Patient care system

ABSTRACT

A patient support apparatus system and patient support apparatus, such as a bed, cot, stretcher, operating table, recliner, or the like, include a litter frame, a support deck, a sensor configured to detect caregiver activity, a transceiver communicating with a server, and a controller. The controller is configured to send alerts or messages to the server when caregiver assignment errors or caregiver inattention issues are identified. An alert is sent when a caregiver has not attended to a patient within a certain period of time, or when a caregiver has not been assigned to a particular patient or a particular location within a healthcare facility to which a patient has been assigned. The patient support apparatus and system are in communication with other healthcare facility systems and devices that gather and share information and data to alert caregivers in an effort to avoid patient neglect.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. provisional patent applicationSer. No. 62/826,097 filed Mar. 29, 2019, by inventors Thomas Durlach etal. and entitled PATIENT CARE SYSTEM, the complete disclosure of whichis incorporated herein by reference.

BACKGROUND

The present disclosure relates to patient support apparatuses, such as,but not limited to, beds, cots, stretchers, recliners, chairs, and thelike; and more particularly to a patient support apparatus system thatmonitors caregiver-to-patient assignments, caregiver activities at thepatient support apparatus, and/or other caregiving activities and sendsan alert if there is a patient with no caregiver assigned, or if apatient has not been attended to as expected.

Operation of a healthcare facility, such as a hospital, outpatientfacility, or assisted living home, requires numerous workers skilled inproviding healthcare. Proper staffing and assignment of doctors, nurses,and other caregivers is an important factor in delivering quality careto the patients. Caregivers are typically assigned a specific patient,patient support apparatus, or room within the healthcare facility. Theseassignments can be based on various factors including the availabilityof caregivers, qualifications of available caregivers, the number ofavailable beds in the unit, the current utilization of the beds in theunit, the existing responsibilities of the caregivers, and the like.Despite the various systems utilized within the healthcare facilityaimed at preventing sub-par patient care, the assigned caregiver may notperform the patient care in a timely manner, or a caregiver assignmenterror can occur and a patient may not be assigned a caregiver and may beoverlooked or neglected. Caregiver assignments are further complicatedif a patient is moved or transported to another location within thehealthcare facility. In some cases, a patient may be “lost” orunaccounted for.

SUMMARY

In its various embodiments, the present disclosure provides a patientcare system configured to help healthcare facility staff, includingdoctors, nurses, and technicians, reduce or avoid caregiver assignmenterrors and caregiver inattention issues. The system generates and issuesan alert when such errors or issues are identified. In some embodiments,an alert may be issued when a patient has not been attended to by acaregiver within a period of time greater than a certain period. Inother embodiments, an alarm may be issued when a caregiver has not beenassigned to a particular location within the healthcare facility,generally a hospital or treatment room or bay, to which a patient hasbeen assigned. The patient support apparatus can communicate withmultiple other healthcare facility systems and devices that gather andshare data to aid caregivers in avoiding patient neglect. These and/orother features are disclosed in the various embodiments discussedherein.

According to one embodiment of the present disclosure, a patient supportapparatus is provided that includes a litter frame, a support decksupported on the litter frame and adapted to support a patient thereon,and a sensor configured to detect caregiver activity. The patientsupport apparatus also includes a transceiver, a timer, and acontroller. The transceiver communicates with a server and thecontroller communicates with the sensors, the timer, and thetransceiver. The controller is configured to send a caregiver inactivitymessage to the server when caregiver activity has not been detected fora period of time greater than a predetermined period of time.

In some embodiments, the patient support apparatus includes a caregivercontrol panel, and detecting caregiver activity includes detecting whenany controls on the caregiver control panel are touched or otherwiseactivated.

According to some embodiments, the caregiver control panel includescontrols for raising and lowering the litter frame, changing theposition of a section of the support deck, activating and deactivating abrake, controlling a patient support apparatus exit alert, taking aweight reading, locking out one or more functions, setting an alert, andany combination of these controls and the like.

In some embodiments, the predetermined period of time for detectingcaregiver activity is received from the server via the transceiver. Inother embodiments, the predetermined period of time is input or receivedby the controller from a caregiver control panel coupled to the patientsupport apparatus or an electronic medical records (EMR) server.

According to some embodiments, the sensor is adapted to detect audiocommunication between the patient and a remotely located caregiver. Theaudio communication takes place via a nurse call communication moduletypically coupled to the patient support apparatus.

In some embodiments, the patient support apparatus includes a clock, andthe predetermined period of time is based on the time of day.

In other embodiments, the patient support apparatus includes a sleepsensor adapted to sense a patient's sleep state and to communicate suchwith the controller. In such embodiments, the predetermined period oftime may be based on the patient's sensed sleep state.

According to still other embodiments, the patient support apparatusincludes a patient control panel and a caregiver control panel. Thecontroller is adapted to detect caregiver activity any time a control onthe caregiver control panel is activated, yet the controller does notdetect caregiver activity when the patient control panel is activated.The patient support apparatus may include more than one patient controlpanel and more than one caregiver control panel.

In some embodiments, the patient support apparatus includes a patientpresence sensor configured to detect the presence of a patient on thesupport deck. The patient presence sensor is in communication with thecontroller.

According to some embodiments, the predetermined period of time variesbased on whether the patient's presence is sensed or not on the patientsupport apparatus.

According to still other embodiments, a caregiver inactivity message isnot sent if a patient is not present on the support deck when thepredetermined period of time expires.

In still other embodiments, the predetermined period of time does notstart until a patient's presence is detected on the support deck.

According to another embodiment of the present disclosure, a patientsupport apparatus is provided that includes a litter frame, a supportdeck supported on the litter frame and adapted to support a patientthereon, and a caregiver control panel having a plurality of caregivercontrols adapted to be activated by a caregiver. The patient supportapparatus further includes a transceiver adapted to communicate with aserver and a controller in communication with the caregiver controlpanel and the transceiver. The controller is adapted to send a caregiveractivity message to the server in response to one or more of thecaregiver controls being activated.

In another embodiment, the controller is adapted to send a caregiveractivity message in response to a caregiver communicating with thepatient via a nurse call speaker that is communicatively coupled to thepatient support apparatus.

In some embodiments, a caregiver activity message is sent to the servereach time any of the caregiver control panels are activated. In otherembodiments, only a single caregiver activity message is sent to theserver for multiple caregiver control panel activations if the multipleactivations occur within a predetermined period of time.

In some embodiments, the controller is adapted to send a caregiverinactivity message to the server when the caregiver control panel hasnot been activated within a predetermined time period.

According to some embodiments, the predetermined period of time fordetecting caregiver activity is received by the controller from apatient support apparatus server, the caregiver control panel, or anelectronic medical records (EMR) server.

According to another embodiment of the present disclosure, a patientsupport apparatus system is provided that includes a litter frame, asupport deck supported on the litter frame and adapted to support apatient thereon, a sensor adapted to detect a presence of the patient, atransceiver, and a controller in communication with the sensor and thetransceiver. The patient support apparatus system further includes aserver in communication with the patient support apparatus and thecontroller via the transceiver. The server is also in communication witha caregiver assignment server that stores caregiver assignments tolocations within the healthcare facility. Further, the server isconfigured to receive location data regarding a current location of thepatient support apparatus. The server is adapted to determine if acaregiver has been assigned to the current location of the patientsupport apparatus, and to issue an alert if the server determines that acaregiver has not been assigned to the current location of the patientsupport apparatus.

In some embodiments, an alert is not sent if a patient is not determinedby the sensor to be present on the support deck.

According to some embodiments, the patient support apparatus includes alocation detector adapted to receive a location identifier from a fixedlocator when the patient support apparatus is positioned adjacent thefixed locator.

In some embodiments, the current location of the patient supportapparatus is a room within the healthcare facility.

In other embodiments, the server is configured to request the caregiverassignment from the caregiver assignment server whenever the currentlocation of the patient support apparatus changes. Additionally, oralternatively, the server is configured to request the caregiverassignment from the caregiver assignment server whenever a caregiverassignment changes.

According to another embodiment, the server is configured to receivecaregiver location data from a real time locating and tracking serverindicating the locations of caregivers within the healthcare facility.The server is also adapted to use the location data to determine if acaregiver has visited a location, corresponding to the locationidentifier, within the healthcare facility within the predeterminedamount of time. The server issues an inactivity alert if a caregiver hasnot visited the location within the predetermined amount of time.

In some embodiments, the server is in communication with an electronicmedical records (EMR) server that stores patient records. The serverretrieves the patient record from the EMR server for the patientassociated with the patient support apparatus and determines if updatesto the patient record have occurred within a predetermined amount oftime. The server issues an inactivity alert if the patient record hasnot been updated within the predetermined amount of time.

According to some embodiments, the patient support apparatus includes atimer in communication with the controller. The controller sends acaregiver inactivity message to the server when caregiver activity hasnot been detected for a period of time greater than a predeterminedperiod of time.

In some embodiments, the patient support apparatus includes a caregivercontrol panel in communication with the controller. The controller isadapted to send a caregiver activity message to the server in responseto any one or more of the caregiver controls being activated.

According to another embodiment of the present disclosure, a patientsupport apparatus system is provided that includes a litter frame, asupport deck supported on the litter frame and adapted to support apatient thereon, a sensor adapted to detect a presence of the patient, atransceiver, and a controller in communication with the sensor and thetransceiver. The patient support apparatus system further includes aserver in communication with the patient support apparatus via thetransceiver. The server is also in communication with anadmission/discharge/tracking (ADT) server that stores patient locationinformation. The server receives location data regarding a currentlocation of the patient to determine if a caregiver has been assigned tothe current location of the patient. The server issues an alert if theserver determines that a caregiver has not been assigned to the currentlocation of the patient.

According to another embodiment of the present disclosure, a patientsupport apparatus system is provided that includes a litter frame, asupport deck supported on the litter frame and adapted to support apatient thereon, a sensor adapted to detect a presence of the patient, atransceiver, and a controller in communication with the sensor and thetransceiver. The patient support apparatus system further includes aserver in communication with the patient support apparatus via thetransceiver. The server is also in communication with an electronicmedical records (EMR) server that stores patient records. The serverretrieves a particular patient record from the EMR server correspondingto the patient to determine if updates to the particular patient recordhave occurred within a predetermined amount of time. The server alsoissues an inactivity alert if the particular patient record has not beenupdated within the predetermined amount of time.

In some embodiments, the inactivity alert is not issued or sent if apatient is not present on the support deck.

According to some embodiments, the patient support apparatus includes alocation detector adapted to receive a location identifier from a fixedlocator when the patient support apparatus is positioned adjacent thefixed locator. The server may also receive caregiver location data froma real time locating and tracking server indicating locations ofcaregivers within the healthcare facility. The server uses the locationdata to determine if a caregiver has visited a location, correspondingto the location identifier, within the healthcare facility within thepredetermined amount of time. The server issues an inactivity alert if acaregiver has not visited the location corresponding to the locationidentifier within the predetermined amount of time.

In still other embodiments, the server is in communication with anadmission/discharge/tracking (ADT) server that stores patient locationinformation. The server receives location data regarding a currentlocation of the patient to determine if a caregiver has been assigned tothe current location of the patient. The server issues an alert if theserver determines that a caregiver has not been assigned to the currentlocation of the patient.

According to other embodiments, the server is configured to determine ifa particular patient record includes a prescribed event to occur withina prescribed time. The server monitors whether the prescribed eventoccurs at the prescribed time, and issues an inactivity alert if theprescribed event does not occur within the prescribed time.

In some embodiments, the prescribed event includes performing a therapyutilizing a mattress supported on the support deck. The server receivesstatus data from the patient support apparatus indicating when thetherapy is performed and utilizes the status data to determine if theprescribed event is performed within the prescribed time.

In other embodiments, the prescribed event includes performing anactivity that is to be documented to the particular patient recordstored at the EMR server. The server is configured to request an updatedparticular patient record from the EMR server to determine if theprescribed event is performed within the prescribed time.

In some embodiments, the activity includes visiting the patient at aregular time interval. In other embodiments, the activity includestaking a weight reading of the patient. In still other embodiments, theactivity includes performing a fall risk assessment of the patient orperforming a bed sore risk assessment of the patient.

According to still another embodiment of the present disclosure, apatient support apparatus system is provided that includes a litterframe, a support deck supported on the litter frame and adapted tosupport a patient thereon, and a location detector adapted to receive alocation identifier from a fixed locator when the patient supportapparatus is positioned adjacent the fixed locator. The patient supportapparatus system also includes a transceiver, a controller adapted totransmit the location identifier, and a server adapted to receive thelocation identifier from the patient support apparatus and correlate thelocation identifier with a location within the healthcare facility. Theserver receives caregiver location data from a real time locating andtracking server, indicating locations of caregivers within thehealthcare facility. The server uses the location data to determine if acaregiver has visited a location, corresponding to the locationidentifier, within the healthcare facility within a predetermined amountof time. Further, the server issues an inactivity alert if a caregiverhas not visited the location corresponding to the location identifierwithin the predetermined amount of time.

In some embodiments, the locating and tracking server tracks a caregiverlocation badge worn by the caregiver.

Before the various embodiments disclosed herein are explained in detail,it is to be understood that the claims are not to be limited to thedetails of operation, to the details of construction, or to thearrangement of the components set forth in the following description orillustrated in the drawings. The embodiments described herein arecapable of being practiced or being carried out in alternative ways notexpressly disclosed herein. Also, it is to be understood that thephraseology and terminology used herein are for the purpose ofdescription and should not be regarded as limiting. The use of“including” and “comprising” and variations thereof is meant toencompass the items listed thereafter and equivalents thereof as well asadditional items and equivalents thereof. Further, enumeration may beused in the description of various embodiments. Unless otherwiseexpressly stated, the use of enumeration should not be construed aslimiting the claims to any specific order or number of components. Norshould the use of enumeration be construed as excluding from the scopeof the claims any additional steps or components that might be combinedwith or into the enumerated steps or components.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is perspective view of a patient support apparatus into which oneor more of the features of the present disclosure may be incorporated;

FIG. 2 is a diagram of one embodiment of a control system that may beused with the patient support apparatus of FIG. 1, or with any of theother patient support apparatus embodiments described herein;

FIG. 3 is a diagram of the hardware and data structures used in apatient care system according to one aspect of the present disclosure;

FIG. 4 is a diagram of various software algorithms used in at least oneembodiment of the patient care system of the present disclosure;

FIG. 5 is a flow chart of the caregiver inactivity algorithm of FIG. 4executed by the patient support apparatus of FIG. 1;

FIG. 6 is a flow chart of the caregiver activity algorithm of FIG. 4executed by the patient support apparatus of FIG. 1;

FIG. 7 is a flowchart of the caregiver assignment monitoring algorithmof FIG. 4 executed by the patient care server of FIG. 3;

FIG. 8 is a flow chart of the Electronic Medical Records updatemonitoring algorithm of FIG. 4 executed by the patient care server ofFIG. 3;

FIG. 9 is a flowchart of the prescribed therapy monitoring algorithm ofFIG. 4 executed by the patient care server of FIG. 3;

FIG. 10 is a flowchart of a patient neglect detection algorithm executedby various components of another embodiment of the patient care systemof the present disclosure; and

FIG. 11 is a flowchart of a staff assignment error algorithm executed byvarious components of yet another embodiment of the patient care systemof the present disclosure.

DETAILED DESCRIPTION OF THE EMBODIMENTS

A patient care system 106 according to one embodiment of the presentdisclosure includes a patient support apparatus 20, such as the patientsupport apparatus 20 which is shown in FIG. 1. Although the particularform of patient support apparatus 20 illustrated in FIG. 1 is a bedadapted for use in a hospital or other medical setting, it will beunderstood that the patient support apparatus 20 could, in differentembodiments, be a cot, a stretcher, a gurney, a recliner, or any otherstructure capable of supporting a patient that may be used during timeswhen the patient is not accompanied by a caregiver. For purposes of thefollowing written description, the patient support apparatus 20 will bedescribed as a bed with the understanding the following writtendescription applies to these other types of patient support apparatuses.

In general, the patient support apparatus 20 includes a base 22 having aplurality of wheels 24, a lift subsystem comprising a pair of lifts 26supported on the base, a litter frame 28 supported on the lifts 26, anda support deck 30 supported on the litter frame 28. Patient supportapparatus 20 further includes a headboard (not shown), a footboard 32,and a plurality of siderails 34. Siderails 34 are all shown in a raisedposition in FIG. 1 but are each individually movable to a lower positionin which ingress into, and egress out of, patient support apparatus 20is not obstructed by the lowered siderails 34. In some embodiments, thesiderails 34 may be moved to one or more intermediate positions as well.

Lifts 26 are adapted to raise and lower litter frame 28 with respect tobase 22. Lifts 26 may be hydraulic actuators, electric actuators, or anyother suitable device for raising and lowering litter frame 28 withrespect to base 22. In the illustrated embodiment, lifts 26 are operableindependently so that the tilting of litter frame 28 with respect tobase 22 can also be adjusted. That is, litter frame 28 includes a headend 36 and a foot end 38, each of whose height can be independentlyadjusted by the nearest lift 26. The patient support apparatus 20 isdesigned so that when an occupant lies thereon, his or her head will bepositioned adjacent head end 36 and his or her feet will be positionedadjacent foot end 38.

Litter frame 28 provides a structure for supporting support deck 30, theheadboard, footboard 32, and siderails 34. Support deck 30 provides asupport surface for a mattress (not shown in FIG. 1), or other softcushion, so that a person may lie and/or sit thereon. The support deck30 is made of a plurality of sections, some of which are pivotable aboutgenerally horizontal pivot axes. In the embodiment shown in FIG. 1, thesupport deck 30 includes a head section 40, a seat section 42, a thighsection 44, and a foot section 46. Head section 40, which is alsosometimes referred to as a Fowler section, is pivotable about agenerally horizontal pivot axis between a generally horizontalorientation (not shown in FIG. 1) and a plurality of raised positions(one of which is shown in FIG. 1). Thigh section 44 and foot section 46may also be pivotable about generally horizontal pivot axes.

Patient support apparatus 20 further includes a plurality of userinterfaces or control panels 48 that enable a user of patient supportapparatus 20, such as a patient and/or an associated caregiver, tocontrol one or more aspects of patient support apparatus 20. In theembodiment shown in FIG. 1, patient support apparatus 20 includes afootboard control panel 48 a, a pair of inner siderail patient controlpanels 48 b (only one of which is visible), and a pair of outer siderailcaregiver control panels 48 c (only one of which is visible). Footboardcontrol panel 48 a and outer siderail control panels 48 c are intendedto be used by caregivers, or other authorized personnel, while innersiderail control panels 48 b are intended to be used by the patientassociated with patient support apparatus 20. Not all of the controlpanels 48 include the same controls and/or functionality. In theillustrated embodiment, footboard control panel 48 a includes asubstantially complete set of controls for controlling patient supportapparatus 20 while control panels 48 b and 48 c include a selectedsubset of those controls. Control panels 48 may include controls forallowing a user to do one or more of the following: change a height ofsupport deck 30, raise or lower head section 40, activate and deactivatea brake for wheels 24, arm an exit detection system, take a weightreading of the patient, activate and deactivate a propulsion system, andcommunicate with a healthcare facility computer network installed in thehealthcare facility in which patient support apparatus 20 is positioned.Inner siderail control panels 48 b may also include a nurse call controlthat enables a patient to call a nurse. A speaker and microphone areincluded in order to allow the patient to orally communicate with theremotely positioned nurse.

Footboard control panel 48 a is shown implemented in FIG. 1 as having aplurality of individual controls. These controls may be implemented asbuttons, dials, switches, or other devices. Any of control panels 48 a-cmay also include a display for displaying information regarding patientsupport apparatus 20. The display may be a touchscreen in someembodiments.

The mechanical construction of those aspects of patient supportapparatus 20 not explicitly described herein may be the same as, ornearly the same as, the mechanical construction of the Model 3002 S3 bedmanufactured and sold by Stryker Corporation of Kalamazoo, Mic. Thismechanical construction is described in greater detail in the StrykerMaintenance Manual for the MedSurg Bed, Model 3002 S3, published in 2010by Stryker Corporation of Kalamazoo, Mich., the complete disclosure ofwhich is incorporated herein by reference. It will be understood bythose skilled in the art that those aspects of patient support apparatus20 not explicitly described herein can alternatively be designed withother types of mechanical constructions, such as, but not limited to,those described in commonly assigned, U.S. Pat. No. 7,690,059 issued toLemire et al., and entitled HOSPITAL BED; and/or commonly assigned U.S.Pat. publication No. 2007/0163045 filed by Becker et al. and entitledPATIENT HANDLING DEVICE INCLUDING LOCAL STATUS INDICATION, ONE-TOUCHFOWLER ANGLE ADJUSTMENT, AND POWER-ON ALARM CONFIGURATION, the completedisclosures of both of which are also hereby incorporated herein byreference. The mechanical construction of those aspects of patientsupport apparatus 20 not explicitly described herein may also take onforms different from what is disclosed in the aforementioned references.

Referring now to FIG. 2, patient support apparatus 20 includes a controlsystem 50 comprising a plurality of control panels 48 a-c, a pluralityof actuators 100, 104, a controller 58, a transceiver 68, a timer 74, aclock 76, one or more sensors 62, 142, 144, a nurse call button 90, ascale/exit detection system 94, a microphone 88, and a speaker 96.Scale/exit detection system 94 is used to detect the weight of anoccupant of the patient support apparatus 20 and/or as an exit detectionsystem. The particular structural details of scale/exit detection system94 can vary widely. In the embodiment shown in FIG. 2, scale/exitdetection system 94 includes a plurality of load cells 54 and ascale/exit detection system controller 98 adapted to process the outputsfrom the load cells to determine a weight of the patient and/or todetermine when the patient has exited, or is about to exit, from supportdeck 30. In some embodiments, load cells 54 may be replaced with linearvariable displacement transducers and/or any one or more capacitive,inductive, and/or resistive transducers that are configured to produce achanging output in response to changes in the force exerted againstthem. Still other types of forces sensors may be used with patientsupport apparatus 20.

Load cells 54 are configured to support litter frame 28. Morespecifically, load cells 54 are configured such that they providecomplete mechanical support for litter frame 28 and all of thecomponents that are supported on litter frame 28 (e.g. support deck 30,footboard 32, the headboard, siderails 34, etc.). Because of thisconstruction, load cells 54 detect the weight of not only thosecomponents of patient support apparatus 20 that are supported by litterframe 28 (including litter frame 28 itself), but also any objects orpersons who are wholly or partially being supported by support deck 30.Load cells 54 are adapted to detect downward forces exerted by anoccupant of support deck 30. Thus, when an occupant is positioned onsupport deck 30 and substantially still (i.e. not moving in a mannerinvolving accelerations that cause forces to be exerted against supportdeck 30), load cells 54 detect the weight of the occupant (as well asthe weight of any components of patient support apparatus 20 that aresupported—directly or indirectly—by load cells 54).

When functioning as a scale system, the outputs of the load cells 54 aresummed by processor 98 to detect a weight of the occupant. Whenfunctioning as an exit detection system, the outputs of the load cells54 are read and used to detect when an occupant has exited the apparatus20, or when an occupant may be about to exit the apparatus 20. Oneexemplary scale/exit detection system 94 is described in U.S. PatentApplication Pub. No. 2017/0003159, filed on Jun. 17, 2016, entitledPERSON SUPPORT APPARATUS WITH LOAD CELLS, which is hereby incorporatedby reference herein in its entirety. Another exemplary exit detectionsystem is described in U.S. Pat. No. 5,276,432, filed on Jan. 15, 1992,entitled PATIENT EXIT DETECTION MECHANISM FOR HOSPITAL BED, which ishereby incorporated by reference herein in its entirety. Other types ofscale and/or exit detection systems may be used.

Actuators 100, 104 of control system 50 are adapted to control themovement of lifts 26 and head section 40, respectively. Actuators 100and 104 may be linear actuators, rotary actuators, or other types ofactuators capable of pivoting head section 40 about a generallyhorizontal pivot axis or lifting litter frame 28. Actuators 100, 104 maybe electrically powered, hydraulic, electro-hydraulic, pneumatic, or thelike. Actuators 100, 104 are controlled by one or more controlspositioned on one or more of the control panels 48 a-48 c.

Control system 50 includes, in some embodiments, one or more patientdetection sensors 62 that are adapted to detect when a patient ispresent on support deck 30. In some embodiments, control system 50 omitspatient detection sensors 62 and utilizes the outputs of load cells 54to detect the presence and/or absence of a patient on patient supportapparatus 20. In other embodiments, control system omits patientdetection sensors 62 altogether and functions as described below withoutdetecting the absence/presence of a patient. In the embodiment shown inFIG. 2, control system 50 includes both patient detection sensors 62 andload cells 54.

When patient detection sensors 62 are included, such sensors 62 mayinclude one or more of a variety of different sensors that are able todetect the absence or presence of the patient on patient supportapparatus 20. In some embodiments, sensors 62 are adapted to detect oneor more vital signs of the patient when the patient is supported onpatient support apparatus 20. In such embodiments, the detection of apatient's vital sign is used as confirmation of the patient's presence,and the absence of a detected vital sign is interpreted as the patientbeing absent. Several methods and sensors for detecting a patient'svital signs are disclosed in commonly assigned U.S. patent applicationSer. No. 62/253,167, filed Nov. 10, 2015, by inventors Marko Kostic etal. and entitled PERSON SUPPORT APPARATUSES WITH ACCELERATION DETECTION,the complete disclosure of which is incorporated herein by reference. Apatient's breathing rate and/or heart rate may also be detected usingload cells 54, such as is disclosed in commonly assigned U.S. Pat. No.7,699,784 issued to Wan Fong et al. and entitled SYSTEM FOR DETECTINGAND MONITORING VITAL SIGNS, the complete disclosure of which is herebyincorporated herein by reference. Still other methods and/or sensors canbe used to detect a patient's vital signs, and thereby determine if apatient is present on patient support apparatus 20 or not.

Detecting a patient's vital signs may also be performed in othermanners. For example, in some embodiments, patient presence sensors 62are incorporated into a mattress, such as the mattress disclosed incommonly assigned U.S. patent application Ser. Nos. 13/836,813 and61/697,010, entitled INFLATABLE MATTRESS AND CONTROL METHODS and PATIENTSUPPORT, respectively, the former of which was filed Mar. 15, 2013 andthe latter of which was filed Sep. 5, 2012, the complete disclosures ofboth of which are hereby incorporated herein by reference. Whenincorporated into a mattress, the sensor 62, in some embodiments,detects respiration and/or heart rates by a pressure sensor includedwithin the mattress that detects fluid pressure changes within one ormore bladders contained within the mattress. Such fluid pressure changesare filtered for frequencies within those of the normal heart rate andbreathing rate and processed, such as through Fourier analysis, orotherwise, to yield a heart rate and/or respiration rate. In embodimentsusing the mattress construction disclosed in the above-referenced Ser.No. 13/836,813 and/or 61/697,010 applications, the mattress alsoincludes a plurality of depth sensors that measure the depth which thepatient has sunk into the mattress. These depth sensor signals may becombined with the air pressure signals to determine a patient'sbreathing rate and or heart rate.

In other embodiments, patient detection sensors 62 are implemented todetect the patient's presence/absence in manners that don't involve thedetection of vital signs. For example, in some embodiments, patientdetection sensors 62 include one or more thermal sensors that detect theabsence/presence of the occupant and/or the position of the occupant'shead on the personal support apparatus 20. Further details of such athermal sensing system are disclosed in commonly assigned U.S. patentapplication Ser. No. 14/692,871 filed Apr. 22, 2015, by inventors MarkoKostic et al. and entitled PERSON SUPPORT APPARATUS WITH POSITIONMONITORING, the complete disclosure of which is incorporated herein byreference.

In still other embodiments, patient detection sensors 62 are configuredto detect the absence or presence of an occupant using one or more ofthe methods disclosed in commonly assigned U.S. patent application Ser.No. 14/928,513 filed Oct. 30, 2015, by inventors Richard Derenne et al.and entitled PERSON SUPPORT APPARATUSES WITH PATIENT MOBILITYMONITORING, the complete disclosure of which is also hereby incorporatedherein by reference. In still other embodiments, patient detectionsensors 62 include one or more video and/or infrared cameras detectingan occupant's presence, absence, and/or position, such as disclosed incommonly assigned U.S. patent application Ser. No. 14/578,630 filed Dec.22, 2014, by inventors Richard Derenne et al. and entitled VIDEOMONITORING SYSTEM, the complete disclosure of which is also herebyincorporated herein by reference. Such cameras are positioned on thepatient support apparatus 20 in some embodiments; position off-board thepatient support apparatus 20 in other embodiments; and include both oneor more on-board cameras and one or more off-board cameras in stillother embodiments.

In yet another alternative embodiment, patient presence sensors 62 sensethe presence, absence, and/or position of an occupant using a pressuresensing mat on which, or above which, the patient lies. The pressuresensing mat may be positioned on top of, or underneath, the mattress onsupport deck 30, such as is disclosed in commonly assigned U.S. patentapplication Ser. No. 14/003,157 filed Mar. 2, 2012, by inventors JoshuaMix et al. and entitled SENSING SYSTEM FOR PATIENT SUPPORTS, thecomplete disclosure of which is also incorporated herein by reference.This pressure sensing mat is also able to detect the overall shape ofthe patient's weight or the object's weight (e.g. the weight footprint)when positioned on the mattress. This overall shape is processed byeither controller 58, or a controller within the flexible pressuresensing mat, to determine whether the shape corresponds to a human or anobject. The result of this determination is used by controller 58 todistinguish between the objects and humans moving onto or off thepatient support apparatus.

In yet another embodiment, patient presence sensors 62 are adapted todetect a bracelet, tag, or other radio-frequency object worn by thepatient using one or more near field transceivers incorporated intopatient support apparatus 20. Such sensors 62 are able to communicatevia near field communication with near field tags, bracelets, etc. wornby the patients. Examples of near field transceivers that may beincorporated into patient support apparatuses and used to detectpatient-worn tags, bracelets, etc. are disclosed in commonly assignedU.S. patent application Ser. No. 13/802,992, filed Mar. 14, 2013 byapplicants Michael Hayes et al., and entitled COMMUNICATION SYSTEMS FORPATIENT SUPPORT APPARATUSES, the complete disclosure of which is herebyincorporated herein by reference. Still other types of sensors thatdetect the patient's presence in other manners may be used.

Control system 50 also includes, in the embodiment shown in FIG. 2, oneor more caregiver presence sensors 144. Caregiver presence sensors 144may take on a variety of different forms. In one embodiment, caregiverpresence sensors 144 are one or more near field sensors that are adaptedto detect near field cards, tags, or the like that are carried bycaregivers. In another embodiment, caregiver presence sensors 144 are RFID sensors that are adapted to detect RF ID cards, tags, or the likethat are worn or carried by caregivers. In still another embodiment,patient support apparatus 20 includes one or more cameras (visible lightand/or infrared light) that have fields of view in the areas adjacentpatient support apparatus 20 and are able to detect the presence of acaregiver within those fields of view. One example of a patient supportapparatus 20 having such cameras built into it is found in commonlyassigned U.S. Pat. No. 9,814,410 issued to Kostic et al. and entitledPERSON SUPPORT APPARATUS WITH POSITION MONITORING, the completedisclosure of which is incorporated herein by reference. In still otherembodiments, one or more caregiver presence sensors 144 may beincorporated into patient care system 106 that are not positioned onpatient support apparatus 20. For example, one or more cameras may bepositioned within the room in which patient support apparatus 20 islocated and adapted to capture images of the caregivers, when present,and report that information to patient care server 70. One such suitablecamera system is disclosed in commonly assigned U.S. Pat. No. 10,121,070issued to Derenne et al. and entitled VIDEO MONITORING SYSTEM, thecomplete disclosure of which is incorporated herein by reference. Stillother types of caregiver presence detectors 144 may be utilized, eitherin lieu of, or in addition to, the caregiver presence sensors 144discussed herein.

Controller 58 is constructed of any electrical component, or group ofelectrical components, that are capable of carrying out the functionsdescribed herein. In many embodiments, controller 58 is a conventionalmicrocontroller, although not all such embodiments need include amicrocontroller. In general, controller 58 includes any one or moremicroprocessors, microcontrollers, field programmable gate arrays,systems on a chip, volatile or nonvolatile memory, discrete circuitry,and/or other hardware, software, or firmware that is capable of carryingout the functions described herein, as would be known to one of ordinaryskill in the art. Such components can be physically configured in anysuitable manner, such as by mounting them to one or more circuit boards,or arranging them in other manners, whether combined into a single unitor distributed across multiple units. The instructions followed bycontroller 58 in carrying out the functions described herein, as well asthe data necessary for carrying out these functions, are stored in amemory (not labeled) accessible to controller 58.

Controller 58 is in communication with footboard control panel 48 a, asshown in FIG. 2. Controller 58 also communicates with the inner siderailcontrol panels 48 b and the outer siderail control panels 48 c that arepositioned on patient support apparatus 20. Footboard control panel 48 aand outer siderail control panels 48 c are intended to be used bycaregivers, while inner siderail control panels 48 b are intended to beused by a patient.

Each of the control panels 48 a-c includes a plurality of controls 66for controlling various functions of the patient support apparatus 20.One or more of the controls panels 48 a-c may also or alternativelyinclude a display 64. When included, display 64 is a touch screendisplay in at least some embodiments, although it will be understoodthat a non-touch screen display 64 may alternatively be used. It willalso be understood that any of the control panels 48 a-c may beimplemented without any display at all. Controls 66 can be touchsensitive controls that may be physically implemented in a variety ofdifferent manners. In some embodiments, controls 66 are implemented ascapacitive sensors positioned adjacent display 64 that capacitivelydetect when a user presses them. In other embodiments, controls 66 areimplemented as buttons, switches, or other types of force ortouch-sensitive devices. In still other embodiments, one or more ofcontrols 66 may be incorporated into touchscreen display 64. Still othervariations are possible.

The controls 66 of control panels 48 a-c include controls forraising/lowering the litter frame 28, changing the position of a section40-46 of the support deck 30, activating/deactivating a brake,controlling scale/exit detection system 94 (e.g. taking a weightreading, arming the exit detection system 94, etc.), locking out one ormore functions, setting an alert, inputting patient information and/ortherapy data (e.g. a prescribed turning frequency, etc.), and/or othercontrols. At least one of the inner control panels 48 b also include thenurse call button 90, speaker 96, and microphone 88 which collectivelyenable the patient to call and talk to a remotely positioned nurse, suchas a nurse located at a corresponding nurses' station within thehealthcare facility.

Patient support apparatus 20 communicates with a healthcare facilitynetwork 72 via transceiver 68 (FIG. 2). In some embodiments, transceiver68 is a wireless transceiver adapted to communicate with one or morewireless access points 80 of the healthcare facility's local areanetwork 72. In such embodiments, transceiver 68 may be a WiFitransceiver. In other embodiments, transceiver 68 may be a wiredtransceiver that communicates with network 72 over a wired network, suchas an Ethernet cable or the like. Regardless of whether transceiver 68is a wired or wireless transceiver, it enables controller 58 tocommunicate with one or more servers on the healthcare facility'snetwork 72, such as, but not limited to, a patient support apparatusserver 132.

Control system 50 of patient support apparatus 20 also includes anurse-call interface 52 (FIG. 2) for communicatively coupling patientsupport apparatus 20 to a conventional nurse call system. Conventionalnurse call systems typically include one or more nurse call servers 92coupled to local area network 72, one or more nurse call outlets 86(FIG. 3) positioned in each patient room, wiring coupling the nurse calloutlets 86 to nurse call server 92, and other structures. In someembodiments, nurse-call interface 52 is a wired interface adapted tocouple to, and communicate with, nurse call outlet 86 via a nurse callcable 56 (FIG. 3). A first end of cable 56 is coupled to nurse-callinterface 52 and the other end is coupled to nurse-call outlet 86. Oneexample of such a wired nurse-call interface is the cable interfacedisclosed in more detail in commonly assigned U.S. patent applicationSer. No. 15/945,437 filed Apr. 4, 2018, by inventors Krishna Bhimavarapuet al. and entitled PATIENT SUPPORT APPARATUSES WITH RECONFIGURABLECOMMUNICATION, the complete disclosure of which is incorporated hereinby reference.

In other embodiments, nurse-call interface 52 is a wireless interfaceadapted to communicate wirelessly with nurse-call outlet 86. Severalexamples of wireless nurse-call interfaces 52 that enable wirelesscommunication between patient support apparatus 20 and an adjacentnurse-call outlet 86 are disclosed in the following commonly assignedpatent references and may be implemented in patient support apparatus 20herein: U.S. patent publication 2016/0038361 filed Aug. 6, 2015, byinventors Krishna S. Bhimavarapu et al. and entitled PATIENT SUPPORTAPPARATUSES WITH WIRELESS HEADWALL COMMUNICATION; U.S. patentapplication Ser. No. 62/600,000 filed Dec. 18, 2017, by inventorAlexander J. Bodurka and entitled SMART HOSPITAL HEADWALL SYSTEM; U.S.patent application Ser. No. 62/587,867 filed Nov. 17, 2017, by inventorsAlexander J. Bodurka et al. and entitled PATIENT SUPPORT APPARATUSESWITH LOCATION/MOVEMENT DETECTION; and U.S. patent application Ser. No.62/598,787 ed Dec. 14, 2017, by inventors Alexander J. Bodurka et al.and entitled HOSPITAL HEADWALL COMMUNICATION SYSTEM, the completedisclosures of all of which are incorporated herein by reference. Stillother types of wireless or wired nurse-call interfaces may, or course,be used.

A timer 74 and/or a clock 76 may also be provided on patient supportapparatus 20 for measuring one or more predetermined periods of timeand/or for determining the current time of day. Timer 74 is operative tomeasure an interval of time having a selected duration representative ofa desired function, protocol, or activity, as will be discussed morebelow. The timer 74 and clock 76 are in communication with controller58. In some embodiments, timer 74 measures one or more predeterminedtime periods that are set by a user utilizing one of the caregivercontrol panels 48 a and/or 48 c, and/or that are set by a server onnetwork 72, such as a patient care server 70 and/or patient supportapparatus server 132. In such embodiments, the server communicates thepredetermined time period to controller 58 via transceiver 68. Timer 74may also and/or alternatively be built into a microcontroller and/ormicroprocessor of controller 58. Timer 74 is adapted to be reset bycontroller 58 in response to the predetermined time period expiringand/or one or more other actions, as will be discussed in greater detailbelow.

FIG. 3 depicts the hardware and data structures used in one embodimentof a patient care system 106 according to the present disclosure.Patient care system 106 includes one or more patient support apparatuses20 in communication with a local area network 72 of the healthcarefacility that includes a patient care server 70. In some embodiments ofpatient care system 106, patient care server 70 communicates with andutilizes the data contained within other conventional servers coupled tolocal area network 72. In other embodiments, patient care server 70 mayoperate without the assistance of any of these servers. It willtherefore be understood that the precise structure and contents of thehealthcare facility network 72 can vary from healthcare facility tohealthcare facility and that patient care system 106 can be implementedwith local area networks having different architectures and/or contentsthan the illustrative example of FIG. 3. Further, the data structuresshown in FIG. 3 depict several examples of the types of data that may bepresent in a given system 106, but are not intended to be eitherexhaustive or exclusive of the types of data structures that differentembodiments of patient care system 106 may include.

As shown, healthcare facility network 72 includes a plurality ofservers, including a conventional Admission, Discharge, and Tracking(ADT) server 84, a conventional nurse call system server 92, aconventional Electronic Medical Records server 102, a caregiverassignment server 112, a caregiver tracking server 122, and a patientsupport apparatus server 132. Healthcare facility network 72 alsoincludes a conventional Internet Gateway 82 that couples healthcarefacility network 72 to the Internet 60, thereby enabling the servers,patient support apparatuses 20, and other applications on network 72 tocommunicate with computers outside of the healthcare facility, such as,but not limited to, a geographically remote cloud-based server 78(which, in at least some embodiments, is operated under the control ofthe manufacturer of patient support apparatuses 20 and performs some, orall, of the functions of patient care server 70). Still further,hospital facility network 72 includes a plurality of conventionalwireless access points 80 and the patient care server 70.

ADT server 84 is used for managing the admission, discharge, andtransfer of patients in the healthcare facility. The ADT server 84stores patient location information, including the identity of patientsand the corresponding rooms (referred to as 403A and 401B in FIG. 3)and/or bays within rooms to which the patients are assigned. Moreparticularly, ADT server 84 includes a patient room assignment table 108that correlates patients to rooms (and/or bays within semi-privaterooms). As shown in the example of FIG. 3, table 108 includes a columnidentifying patients by name and a separate column identifying the roomlocation for each of those patients. It will be understood that table108 may take on other forms and/or include other or additionalinformation, such as, but not limited to, assignments of specificpatients to specific patient support apparatuses. ADT server 84 is incommunication with the patient care server 70 and shares patientlocation information with server 70, as will be discussed in greaterdetail below.

Nurse call server 92 communicates with caregivers and, in someembodiments, forwards alerts and/or other communications to portablewireless devices carried by caregivers and/or to audio stationspositioned within patient rooms. Nurse call server 92 is incommunication with a plurality of nurse call outlets 86 (FIG. 3) thatare installed in locations throughout the healthcare facility, typicallywithin each room in a location adjacent to where patient supportapparatus 20 normally reside. When nurse call cable 56 is coupledbetween patient support apparatus 20 and the nurse call outlet 86, apatient's pressing of the nurse call button 90 (FIG. 2) on a patientsupport apparatus 20 is communicated to nurse call sever 92, as well asthe audio signals generated by the microphone 88 of the patient supportapparatus 20 in response to the patient's speech. Nurse call server 92,or one or more other structures of the nurse call system, forwards theseaudio signals to a nurse's station, or other location, where theassigned caregiver is typically located. When the nurse speaks into amicrophone at that location, the audio signals are forwarded by nursecall server 92 back to patient support apparatus 20 and converted intosound signals by speaker 96. Nurse call server 92 may include acaregiver patient assignment table 114 that identifies which caregivershave been assigned to which patients. Depending upon the particularhealthcare facility and their IT infrastructure, this data may be housedon a different server and/or it may comprise different forms, such as acaregiver assignment table 114 that correlates caregivers to roomsand/or room bays, rather than to patients.

EMR server 102 stores the patients' electronic medical records. EMRserver 102 is in communication with patient care server 70 viahealthcare facility network 72 and stores the digital equivalent ofpaper patient records or charts. Electronic medical records typicallycontain medical information about a patient, such as the patient'streatment, medical history, prescriptions, and/or therapies,assessments, etc. FIG. 3 shows an EMR table 116 illustrating a smallexemplary portion of the type of data that is typically contained withan EMR server 102. Table 116 contains the medical records for eachpatient the healthcare facility and includes, in at least someinstances, data identifying prescribed therapies for those patient. Suchprescribed therapies may include, but are not limited to, medicationsthat are to be taken at prescribed times, therapies to be performed onthe patient, procedures and/or other tasks that are to be performed onthe patient at, or by, a prescribed time, and treatments that are to beperformed on the patient at, or by, a prescribed time. Patient careserver 70 is configured to request certain portions of the data storedin EMR table 116 from server 112, as discussed in more detail below.

Caregiver assignment server 112 is configured to manage the workassignment of caregivers to particular patients, patient supportapparatuses 20, rooms or bays within the facility, and/or units or areaswithin the facility. The caregiver assignment server 112 may alsooversee shift assignments, the performance of specific caregiverfunctions, manage resources within the healthcare facility and othertasks associated with the caregivers. In general, however, caregiverassignment server 112 includes a caregiver assignment table 110 (whichmay, of course, take on other data forms besides a table) that matcheseach caregiver with those rooms and/or bays to which that particularcaregiver is assigned (see FIG. 3). Alternatively, or additionally,caregiver assignment table 110, or server 112, may match each caregiverwith a particular patient. Still further, caregiver assignment table110, or server 112, may also include a data field indicating the timesat which the caregivers are assigned to each of their respective rooms,bays, and/or patients.

Caregiver tracking system tracking server 122 is a real time locatingand tracking server configured to receive caregiver location data formonitoring the location of caregivers within the healthcare facility. Insome embodiments, caregiver tracking server 122 is part of a Real TimeLocation System (RTLS) that keeps track of assets and people within ahealthcare facility. Real time location and tracking data is transmittedto the caregiver tracking server 122 and indicates locations within thehealthcare facility at which a tracked caregiver is detected. Inhealthcare facilities that include a caregiver tracking server 122, eachcaregiver may carry or wear a locating badge 124, or other type ofportable device, that wirelessly communicates with the healthcarefacility network 72 and/or the caregiver tracking server 122 to trackthe whereabouts of the caregiver. The badge 124 can include atransmitter, for example an RFID tag, that emits a signal havinginformation unique to the caregiver. Signal receivers can be positionedin known locations (e.g., a patient room or hallway) throughout thehealthcare facility to detect signals emitted by the badge 124 worn bythe caregiver. Because the signal includes information that is unique tothe caregiver, caregiver tracking server 122 can determine the locationof the caregiver with respect to the known signal receivers by measuringthe received signal strength of the badge signals at each of therespective signal receivers. Alternatively, the badges can be configuredto transmit a short range signal that is only detected by a nearbysignal receiver and the location of the caregiver can be assigned to thelocation of the nearby receiver that receives the badge signal. As yetanother alternative, transmitters can be positioned in known location(s)and transmit a signal that is detected by a receiver included in thebadge 124 carried by the caregiver. The badge uses signal strengthsand/or the detection of short range signals to determine its location(or alternatively forwards its detected signals to another device thatdetermines its location, such as, but not limited to, tracking server122). Other things can be tracked as well, including patients, medicaldevices, and patient support apparatuses 20. Other signalingtechnologies might also be used, such as Wi-Fi or other wireless-signaltechnologies. Tracking server 122 stores the location of the itemsand/or people it tracks in a location table 126 and shares thisinformation with patient care server 70, in at least some embodiments ofpatient care system 106. Tracking server 122 supplements the locationdata received from locators 134 in some embodiments, while in otherembodiments is replaces the location-detection functions server bylocators 134. In still other embodiments, tracking server 122 isomitted.

Patient support apparatus server 132 communicates with patient supportapparatuses 20 via the healthcare access points 80 and the transceiver68 positioned on each of the patient support apparatuses 20. In oneembodiment, patient support apparatus server 132 is a servercommercially offered for sale by Stryker Medical of Kalamazoo, Mich. Inother embodiments, patient support apparatus server 132 is a differenttype of server. Patient support apparatus server 132 coordinatescommunications between the various patient support apparatuses 20 in ahealthcare facility and any of the other applications or servers thatare present on network 72. Thus, patient support apparatus server 132receives communications from apparatuses 20 and then forwards—or makesavailable—information from those communications to selected entities onnetwork 72, as appropriate.

In at least one embodiment, patient support apparatus server 132includes a location table 130 (or other type of data structure) thatcontains information correlating patient support apparatuses 20 withtheir location. In other embodiments, table 130 is stored elsewhere onnetwork 72 and is accessible to server 132. Regardless of where the dataof table 130 resides, location table 130 includes data identifying theunique ID's of a plurality of fixed locators 134 that are positioned inknown locations throughout the healthcare facility, as well as theunique ID's of each of the patient support apparatuses, as will bediscussed in more detail below. The locator ID's are communicated to anadjacent patient support apparatus 20 via short range communication(e.g. infrared) and are included, along with the patient supportapparatus ID, within the messages sent by the patient support apparatus20 to the patient support apparatus server 132. Table 130 correlates thelocator ID's to their location, and also keeps track of which patientsupport apparatuses are currently in which rooms and/or bays using thelocator ID's, the known location of each of the fixed locators 134, andthe patient support apparatus ID's.

In addition to the unique ID of the fixed locator 134 with which anadjacent patient support apparatus 20 is in communication, patientsupport apparatuses 20 are also configured to communicate additionalinformation to patient support apparatus server 132. Such additionalinformation includes the status of various components and/or systemsonboard patient support apparatus 20, such as, but not limited to, thearmed/disarmed state of exit detection system 94, the state of thebrake, the state of siderails 34 (raised or lowered), the height oflitter frame 28, etc.

Fixed locators 134 can be positioned on walls, ceilings, or in otherfixed locations whose absolute positions within the healthcare facilityare known. Further, each fixed locator 134 includes a locationidentifier that uniquely identifies and distinguishes that particularlocator 134 from all other such locators 134 within the healthcarefacility. Location transceivers 136 are incorporated into some or all ofthe patient support apparatuses 20. In the example of FIG. 3, locationtransceiver 136 feeds the unique location ID it receives from anadjacent fixed locator 134 to controller 58 which appends it, orotherwise incorporates it into, messages transmitted to patient supportapparatus server 132 and/or to patient care server 70.

In one embodiment, a healthcare facility may have a plurality of patientsupport apparatuses 20 that are beds that include such transceivers 136,while other types of patient support apparatuses 20—such as stretchers,cots, and the like—might not include such locator transceivers 136.Regardless of which specific patient support apparatuses 20 havelocation transceivers 136 incorporated therein, any such apparatus 20having a location transceiver 136 incorporated therein will be able tocommunicate with a fixed locator 134 when the apparatus is within arelatively close proximity thereto. Such proximity may be on the orderof five to ten feet, or it may be other distances. In some embodiments,location transceiver 136 communicates with fixed locators 134 viainfrared signals, although it will be understood by those skilled in theart that other types of signals may be used for communication betweenlocators 134 and transceiver 136. Fixed locator 134 sends a locationidentifier that uniquely identifies the fixed locator 134 to thelocation transceiver 136 when the patient support apparatus 20 ispositioned sufficiently adjacent the fixed locator 134.

In general, because the locations of locators 134 are known, and becausethe patient support apparatuses can only communicate with a givenlocator 134 (via transceivers 136) when they are within a closeproximity to the given locator 134, the very establishment of suchcommunication indicates that the patient support apparatus 20 is inclose proximity to a given locator 134 whose location is known. Thisallows the location of a patient support apparatus 20 to be determined.Further details of the operation of locators 134 and transceivers 136,as well as the manner in which they can be used to determine location,are found in commonly assigned, U.S. patent application Ser. No.12/573,545 filed Oct. 5, 2009 by applicants David Becker et al. andentitled LOCATION DETECTION SYSTEM FOR A PATIENT HANDLING DEVICE andU.S. patent application Ser. No. 15/909,131 filed Mar. 1, 2018 byapplicants Michael Joseph Hayes et al. and entitled PATIENT SUPPORTAPARATUS COMMUNICATION SYSTEMS, the complete disclosures of which arealso incorporated by reference herein. Fixed locators 134 may also takeon any of the forms, and perform any of the functions, disclosed incommonly assigned U.S. patent application Ser. No. 14/819,844 filed Aug.6, 2015, by inventors Krishna Bhimavarapu et al. and entitled PATIENTSUPPORT APPARATUSES WITH WIRELESS HEADWALL COMMUNICATION; Ser. No.16/217,203 filed Dec. 12, 2018, by inventor Alex Bodurka, and entitledSMART HOSPITAL HEADWALL SYSTEM; Ser. No. 16/193,150 filed Nov. 16, 2018,by inventors Alexander Bodurka et al. and entitled PATIENT SUPPORTAPPARATUSES WITH LOCATION/MOVEMENT DETECTION; and Ser. No. 16/215,911filed Dec. 11, 2018, by inventors Alex Bodurka et al. and entitledHOSPITAL HEADWALL COMMUNICATION SYSTEM, the complete disclosures of allof which are incorporated herein by reference.

As was noted previously, the particular servers on network 72 may varyfrom healthcare facility to healthcare facility. In addition to any ofthe servers previously discussed, network 72 may further include aconventional mobile communications server, a conventional work flowserver and/or a charting server. Such servers are configured to assign,monitor, and/or schedule patient-related tasks to particular caregivers,and/or to forward communications to particular individuals within thehealthcare facility, such as via one or more portable devices (smartphones, pagers, beepers, laptops, etc.). The forwarded communicationsmay include data and/or alerts that originate from patient supportapparatuses 20. In some embodiments, the communications are forwardedvia WiFi to one or more of cell phones, pagers, personal digitalassistants (PDAs), laptop computers, and/or to electronic devices withWiFi communication abilities. Any information that is transmitted tonetwork 72 via transceiver 68 of patient support apparatus 20, or bynetwork transceivers incorporated into other devices, can thereforecause an alert to be forwarded to the appropriate caregiver(s),depending upon the contents of such information.

Patient care server 70 receives information from patient supportapparatuses 20 and, in some embodiments, sends messages and/or data backto patient support apparatuses 20. Patient care server 70 alsocommunicates with one or more of the other servers that are coupled tonetwork 72, as will be discussed in greater detail below. As will alsobe discussed in greater detail below, at least one of the messages thatpatient care server 70 is configured to send to one or more serversand/or other devices in communication with network 72 is an inactivityalert. The inactivity alert indicates that a particular patient supportapparatus 20 has not had any caregiver activity associated with it for acertain time period, and it may behoove the healthcare personnel tocheck on that particular patient support apparatus 20 to ensure that thepatient associated with that patient support apparatus 20 is properlybeing cared for. Patient care server 70 may further be configured toshare data with other servers 84, 92, 102, 122, and 132 on the network72 and/or with other servers located geographically remote from thehealthcare facility (via Internet 60).

FIG. 4 illustrates a set of algorithms carried out by one embodiment ofa patient care system 106 according to the present disclosure. As noted,patient care system 106 includes one or more patient support apparatuses20 and patient care server 70, and the algorithms utilized by patientcare system 106 may be executed solely on patient support apparatuses20, solely on patient care server 70, or a combination of both patientsupport apparatuses 20 and server 70. Patient care system 106 functionsto help ensure that no patients within a healthcare facility areneglected, not visited by healthcare personnel, and/or don't haveprescribed treatment delayed for longer than a threshold amount of time.Patient care system 106 accomplishes this function throughcommunications between patient care server 70 and patient supportapparatuses 20, as well as through communications with one or more ofthe other servers on network 72, as will be discussed in greater detailbelow.

FIG. 4 illustrates a patient care system 106 in which the patientsupport apparatuses 20 execute two algorithms: an activity monitoringalgorithm 150 and an inactivity monitoring algorithm 152. In practice,each patient support apparatus 20 will typically only execute one ofthese two algorithms 150, 152, rather than both algorithms. In aparticular embodiment of patient care system 106, however, a first setof patient support apparatuses 20 might execute one of algorithms 150,152, while a second set of patient support apparatuses 20 might executethe other one of algorithms 150, 152.

Patient care server 70 is shown in FIG. 4 to execute a plurality ofalgorithms, including a caregiver assignment monitoring algorithm 154,an EMR update monitoring algorithm 156, and a prescribed therapymonitoring algorithm 158. In some embodiments of patient care system,patient care server 70 executes all three of these algorithms 154, 156,and 158, while in other embodiments, patient care server 70 executesonly one or two of these algorithms. Still further, in some embodimentsof patient care system 106, patient care server 70 executes one or moreother algorithms different from those shown in FIG. 4, several examplesof which will be discussed in greater detail herein. It will beunderstood that, in some embodiments of patient care system 106, patientsupport apparatuses 20 execute one or more of algorithms 150 and 152while patient care server executes none of algorithms 154, 156, or 158;while in other embodiments of patient care system 106, patient supportapparatuses 20 execute neither of algorithms 150 or 152, while patientcare server 70 executes one or more of algorithms 154, 156, and/or 156.In other words, patient care system 106 may include any combination orpermutation of the various algorithms shown in FIG. 4 in a particularembodiment, as well as combinations and/or permutations of otheralgorithms discussed herein. In some embodiments of system 106, anauthorized administrator of the healthcare facility can access patientcare server 70 via a computer with access to local area network 72 (e.g.computer 120; FIG. 3) and select which ones of algorithms 150-158 he orshe would like have executed. This customization of patient care system106 can also extend to modifying the selected algorithms, includingsetting various threshold, configuring the communication preferences ofalerts, and other items, as will be discussed in greater detail below.

In carrying out algorithms 150-158, patient support apparatuses 20transmit a set of data 128 to patient care server 70, either directly orindirectly, that is utilized by patient care server 70 in theperformance of its functions. In the example shown in FIG. 4, the dataset 128 includes the unique ID of the patient support apparatus 20 (PSAID); an indication of whether or not the patient is currently occupyingthe patient support apparatus 20; an indication of whether or not thepatient is asleep or awake; location information that either identifiesthe location of patient support apparatus 20 directly, or providessufficient information for patient care server 70 to determine thelocation of the patient support apparatus 20 within the healthcarefacility; and inactivity or activity data indicating either the presenceor lack of caregiver interaction with the patient and/or his or herpatient support apparatus 20.

Although FIG. 4 illustrates data set 128 as a single data set, it willbe understood that data set 128 may be transmitted in one or moreseparate messages to patient care server, and that the frequency ofthose individual messages may vary, depending upon the content of themessages. For example, the patient support apparatus 20 may only sendits location information whenever the location of the patient supportapparatus 20 changes, while it may send activity/inactivity status dataat regular intervals and/or at a greater frequency than the locationdata. It will also be understood that the data of data set 128 may becommunicated to patient care server 70 in a variety of differentmanners. For example, in some embodiments, patient support apparatus 20may send certain data of data set 128 directly to the IP address ofpatient care server 70. Other data contained within data set 128 may befirst sent to another server on network 72 before being passed on,either with or without additional processing, to patient care server 70.For example, in some embodiments, patient support apparatuses 20 areconfigured to send their location data directly to patient supportapparatus server 132, and patient care server 70 retrieves this locationfrom patient support apparatus server 132, rather than individually fromeach of the patient support apparatuses 20. It will further beunderstood that, although FIG. 3 illustrates patient care server 70 asseparate from the other servers shown therein, patient care system 106can be modified in some embodiments such that its functionality iscombined with other servers, such as, but not limited to, patientsupport apparatus server 132. It will also be understood that the termserver, as used herein (unless otherwise stated) is being used to referto a software server, not a hardware server. Accordingly, any one ormore of the servers shown in FIG. 3 may be executed on the same physicalmachine, or they may be executed on different physical machines.

The data shown in data set 128 of FIG. 4 is only one example of the typeof data that patient support apparatuses 20 may provide to patient careserver 70. Additions, substitutions, and/or omissions from this set ofdata may be made in different embodiments of patient care system 106. Asone example, in some embodiments, patient support apparatuses 20 do notinclude sensors to detect whether the patient is asleep or not andtherefore do not send data indicating whether the patient is awake orasleep to patient care server 70. In other embodiments, if patientsupport apparatuses 20 are not executing the activity or inactivitymonitoring algorithms 150, 152, the data indicating caregiver activityand/or inactivity is omitted from data set 128, and the data indicatingwhether the patient is present or absent on patient support apparatus 20may also be omitted. Still other variations are possible.

FIG. 5 illustrates one embodiment of inactivity monitoring algorithm152. Inactivity monitoring algorithm 152 is executed by controller 58 ofeach patient support apparatus 20, either wholly or partially (e.g. insome embodiments, one or more other controllers on board patient supportapparatus 20—e.g. scale/exit detection system controller 98—may execute,or assist in, the execution of one or more steps of algorithm 152).Algorithm 152 begins at a step 160 where controller 58 initiates, orresets, timer 74. In some embodiments, algorithm 152 is automaticallyand repetitively executed whenever patient support apparatus 20 isturned on. In other embodiments, algorithm 152 is initiated in responseto a message receiver from patient care server 70, or another authorizeddevice (e.g. mobile electronic device 138) that is in communication withlocal area network 72. Still other manners of starting algorithm 152 maybe implemented.

After starting timer 74 at step 160 (FIG. 5), controller 58 proceeds tostep 162 where it determines whether or not a patient is present onpatient support apparatus 20. Controller executes step 162 inconjunction with one or more of the patient presence sensors 62discussed previously. That is, controller 58 analyzes the outputs fromthe one or more patient presence sensors 62 positioned onboard patientsupport apparatus 20 and determines if the patient is currentlyoccupying the patient support apparatus 20 or not. If there is nopatient present, controller 58 returns to start step 160 and resets thetimer. If a patient is present, controller 58 proceeds to step 164 whereit determines if a nurse call communication is taking place (or hastaken place since the previous time step 164 was performed).

Controller 58 determines if a nurse call communication has taken, or istaking, place by monitoring the particular pin and/or wire within nursecall interface 52 that carries the audio signal from remotely positionednurse. That is, when a patient places a nurse call by activating nursecall button 90, a signal is sent through nurse call interface 52 on aspecific wire or pin that, via the connection of cable 56 to nurse calloutlet 86, notifies the nurse call system the patient has placed a call.If a remotely positioned nurse answers the call and talks back to thepatient, his or her audio signals are transmitted back to nurse callinterface 52, and communicated to a specific audio pin or wire withinnurse call interface 52. Controller 58 forwards these audio signals tospeaker 96 for playback. Controller 58 also monitors these signals todetermine if a nurse call communication is taking place, or has takenplace since the last time step 164 was performed. In the latter case,controller 58 is configured to constantly monitor when audio signals arereceived from a remote nurse and to flag such occurrences including, insome embodiments, a time when the communication took place and/or theamount of time that has elapsed since such occurrences. This flag isstored in memory onboard patient support apparatus 20 and retrieved bycontroller 58 during the performance of step 164.

If a nurse call communication is determined to be taking place, or havetaken place, at step 164, controller 58 returns to step 160 and resetsthe timer. This return to step 160 occurs because it is presumed that ifa patient is talking to a remote nurse, or has recently talked to aremote nurse, he or she is not being neglected. In some embodiments,controller 58 and algorithm 152 may be modified to monitor other aspectsof the nurse call rather than the audio pin (or wire) that deliversaudio signals from the remotely positioned nurse to speaker 96. Forexample, in some embodiments, controller 58 may monitor the pressing ofthe nurse call button 90. The mere pressing of the nurse call button 90,however, is less preferred because it does not exclude the possibilitythat a nurse did not answer the nurse call button 90, and therefore doesnot exclude the possibility that the patient is being neglected.

If controller 58 determines at step 164 that no such communication istaking, or has taken, place, controller 58 proceeds to step 166. At step166, controller 58 determines if any of the caregiver controls onpatient support apparatus 20 are being pressed, or otherwise activated,or if they have been pressed or otherwise activated since the last timestep 166 was executed. The caregiver controls refer to those controlsthat are positioned on either footboard control panel 48 a or either ofthe outside control panels 48 c. Each time one of those controls isactivated, controller 58 is informed of the activation and records (atleast temporarily) the activation. At step 166, controller 58 determinesif any of those activations have occurred since the last time step 166was executed (or, in some embodiments, at any time within apredetermined time window). It should be noted that controls that arepositioned on patient control panels 48 b are not considered during step166. This is because these control panels are presumed to be activatedby the patient, and are therefore not indicative of a caregiver beingpresent at the patient support apparatus. Control panels 48 a and 48 c,on the other hand, are presumed to be controls that are not activated bythe patient, and therefore can be used as an indicator of caregiverpresence or absence.

Step 166 may be modified and/or supplemented in a number of differentmanners. Step 166 is performed essentially to determine if a caregiveris present adjacent patient support apparatus 20, and such adetermination can be made in a variety of different manners. Forexample, in some embodiments, rather than detecting if a caregiveractivates any controls on control panels 48 a or 48 c, patient supportapparatus 20 is constructed to include one or more caregiver presencedetectors 144 that positively detect the presence or absence of a nearbycaregiver. As was described previously, caregiver presence detectors 144are adapted to detect the presence of a caregiver within the vicinity ofpatient support apparatus 20. If a caregiver is detected at step 166(whether through caregiver presence sensors 144 or via the activation ofa control on the caregiver control panel 48 a or 48 c, or a combinationthereof), controller 58 returns back to step 160 and re-starts timer 74.If a caregiver is not detected at step 166, controller 58 proceeds tostep 168.

At step 168, controller 58 determines if the patient is currentlysleeping or not. As will be described more below, controller 58 usesthis determination in some embodiments to select different timethresholds that constitute neglect. That is, when a patient is sleeping,patient care system 106 is configured in some embodiments to allowlonger periods of time to elapse without a caregiver visit beforeissuing an alert. This may allow the patient to sleep longer withoutinterruption and/or allow the caregivers to take care of other dutieswithout needlessly checking in on the patient and/or awaking thepatient. Of course it will be understood that this feature may beomitted in some embodiments, and patient support apparatuses 20 may beincorporated into patient care system 106 that do not include any sleepdetection sensors.

In those embodiments of patient care system 106 that include a sleepdetection sensor 142 built into the patient support apparatuses 20, suchsleep detection sensors 142 may take on a variety of different forms. Insome embodiments, controller 58 utilizes the outputs from load cells 54to determine, either alone or in concert with other data, whether thepatient is awake or asleep. When using load cells 54 to determine thesleep state of the patient, the outputs of the load cells may beanalyzed to detect one or more vital signs of the patient, such as, butnot limited to, the patient's heart rate and/or respiration rate. Onemethod of utilizing load cells to detect a patient's heart rate and/orbreathing rate using load cells is disclosed in commonly assigned U.S.Pat. No. 7,699,784 issued to Wan Fong et al. and entitled SYSTEM FORDETECTING AND MONITORING VITAL SIGNS, the complete disclosure of whichis incorporated herein by reference.

Sleep sensors 142 may take on a variety of other forms. In oneembodiment of patient support apparatuses 20, sleep sensors 142 take onany one or more of the forms of sleep sensors disclosed in commonlyassigned U.S. patent publication 2016/0022218 published Jan. 28, 2016,and filed by inventors Michael Hayes et al. and entitled PATIENT SUPPORTAPPARATUS WITH PATIENT INFORMATION SENSORS, the complete disclosure ofwhich is incorporated herein by reference. Still other types of sleepsensors 142 may be utilized.

If controller 58 determines at step 168 that the patient is asleep,controller 58 proceeds to step 170. If controller 58 determines at step168 that the patient is awake, controller 58 proceeds to step 172. Atstep 172, controller 58 determines if the amount of time that haselapsed since timer 74 was started (and not reset) is greater than afirst threshold. The particular value of the first threshold can varywidely, and as noted previously, may be customized by an authorizedadministrator of the healthcare facility using computer 120. In someembodiments, the value of the first threshold may be in the range ofapproximately two hours. Other ranges can, of course, be utilizeddepending upon how frequently the administrators of the healthcarefacility wish to ensure patient-caregiver interactions. If the amount oftime that has passed, as measured by timer 74, is determined at step 172to be greater than the first threshold (which is a threshold used whenthe patient is awake), controller 58 proceeds to step 174 and issues aninactivity alert. After issuing an inactivity alert at step 174,controller 58 returns to step 160, resets the timer, and restartsalgorithm 152 (FIG. 5).

When controller 58 issues an inactivity alert, it sends a message topatient care server 70 (and/or patient support apparatus server 132)that is then forwarded to appropriate personnel within the healthcarefacility. The particular individual(s) who receive such an alert may becustomized and configured by healthcare personnel using computer 120, orsome other electronic device having authorized access to network 72. Insome embodiments, server 70 (or server 132) sends a message directly toa mobile electronic device 138 (FIG. 3) carried by the caregiver orcaregivers who are assigned to the patient in the patient supportapparatus 20 whose controller 58 sent the alert. The mobile electronicdevice 138 may be a smart phone, a tablet, a laptop, a badge, or someother type of mobile electronic device. The alert message may be anemail, a text message, a phone call, or the like.

Patient care server 70 determines the correct recipients of the alertmessage in one or several manners. In a first embodiment, patient careserver 70 uses the location of the patient support apparatus 20 thatsent the alert message to determine which caregiver is assigned to thepatient who is assigned to that particular patient support apparatus 20.This is accomplished by sending a query to another server that maintainsa correlation between room locations (and/or bay locations) andcaregivers, such as, but not limited to, caregiver assignment server112. As noted previously, caregiver assignment server 112 includes atable 110 that correlates assigned caregivers to room locations. Usingthis information, patient care server 70 determines who the caregiver(s)is/are who should receive the inactivity message generated at step 174.Patient care server 70 has access to a memory in which the phone number,email address, and/or other contact information is stored for each ofthe caregivers within the facility. This contact information may beinput by an authorized administrator during the setup of patient caresystem 106, or it may be obtained by patient care server 70 sending oneor more queries to other servers within the healthcare facility thatcontain this contact information.

In another embodiment, patient care server 70 does not sent out aninactivity alert message directly to any caregivers or other personnel,but instead sends a message to one or more communications servers onnetwork 72 that send out the message to the intended recipient. In stillother embodiments, other manners of sending out the inactivity alertmessage may be utilized.

If controller 58 determines at step 168 of algorithm 152 (FIG. 5) thatthe patient is asleep, it proceeds to step 170, as noted. At step 170,controller 58 makes the same determination it does at step 172, but usesa different time threshold. As noted, controller 58 uses a larger timethreshold at step 170 than it does at step 172. This larger timethreshold is chosen because it is presumed that it is acceptable to haveless frequent patient-caregiver interactions when the patient is asleepthan when the patient is awake. If this assumption is not true ordesirable for a given healthcare facility, patient care system 106 andpatient care server 70 can be modified to execute an algorithm 152 thatutilizes only a single threshold (i.e. algorithm 152 is modified toremove steps 168 and 170, and controller 58 instead proceeds from step166 directly to step 172.)

In those embodiments of algorithm 152 that include step 168 and step170, controller 58 proceeds to step 174 if the timer has a value greaterthan the second threshold, as determined at step 170. At step 174, asdescribed previously, controller 58 issue an inactivity alert and sendsa message to patient care server 70 and/or patient support apparatusserver 132. If controller 58 determines at step 170 that the timer 74has a value that is less than the second threshold, it returns to step162 and proceeds in the manner previously described. Algorithm 152therefore causes controller 58 to issue an alert if none of thecaregiver controls on patient support apparatus 20 are activated withina given time period (e.g. a first or second threshold, depending on thepatient's sleep state) and the caregiver has not communicated with thepatient via the nurse call system and speaker 96 within that given timeperiod. Although it is possible that a caregiver may have visited thepatient in person and simply not pressed any buttons on the patientsupport apparatus 20, this is not typical. Further, in order to avoidincorrect inactivity alerts due to this type of caregiver-patient visit,patient support apparatus 20 and algorithm 152 can be modified to detectsuch visits (with no patient support apparatus 20 interaction), as willbe discussed in greater detail below with respect to caregiver detectionsensors 144 and the inactivity algorithm of FIG. 10.

It will be understood that a variety of modifications can be made toalgorithm 152. These include, but are not limited to, changing the orderof any of the steps of algorithm 152. These also include omitting thedetermination of whether the patient is asleep or not, omitting thedetermination of patient presence, and/or omitting the use of multiplethresholds. Such modifications also include adding one or moreadditional steps, such as, but not limited to, detecting the presence ofa caregiver adjacent the patient support apparatus 20 using one or morecaregiver presence sensors 114, as noted previously. Still further, insome embodiments, one or both of the thresholds may be dynamic andchange value depending upon the time of day, the location of the patientsupport apparatus 20 within the healthcare facility (e.g. differentwards or wings have different values), and/or other factors. Withrespect to the time of day, for example, if clock 76 indicates that thetime of day is within “daytime” hours (e.g. 8 am-10 pm), the first orsecond threshold might be set to a normal period of time (e.g. two tothree hours). In contrast, if clock 76 indicates that the time of day iswithin “nighttime” hours (e.g. 10 pm-8 am), the first or secondthreshold might be extended to a longer period of time (e.g. 4-6 hours).Still other modifications are possible.

FIG. 6 illustrates a caregiver activity monitoring algorithm 150according to one embodiment of the present disclosure. Caregiveractivity monitoring algorithm 150 is, in a general sense, the oppositeof caregiver inactivity monitoring algorithm 152. That is, instead ofsending out a message when caregiver inactivity is detected for morethan a threshold amount of time (as with inactivity monitoring algorithm152), algorithm 150 sends out activity messages whenever caregiveractivity is detected. Patient care server 70 is modified in thisembodiment to process the received activity messages from each of thepatient support apparatuses 20 and to note if no such messages arereceived from a patient support apparatus 20 for more than a thresholdamount. Thus, in general, caregiver activity monitoring algorithm 150offloads from the patient support apparatuses 20 to patient care server70 some of the timing and threshold comparison calculations that areperformed in algorithm 152, as will become clear from the followingdetailed description of activity monitoring algorithm 150.

Activity monitoring algorithm 150 (FIG. 6) begins at step 180. Step 180may be triggered in the same manner as step 160 of algorithm 152. Thatis, in some embodiments, step 180 commences automatically in response topower being turned on to the patient support apparatus, or in responseto any of the other triggering events discussed above with respect tostep 160. Once started, controller 58 proceeds to step 182 anddetermines if a patient is currently present on the patient supportapparatus 20. This is performed in the same manner as step 162 ofalgorithm 152 and need not be described further. If no patient ispresent, controller 58 returns to start step 180. If a patient ispresent, controller 58 proceeds from step 182 to step 184. At step 184,controller 58 determines if a patient-nurse call communication has takenplace, or is currently taken place. This is performed in the same manneras step 164 of algorithm 152 and need not be described further. If sucha communication is taking place, or has taken place since the lastiteration of algorithm 150, controller 58 proceeds to step 192. At step192, controller 58 sends an activity message to patient care server 70using transceiver 68 (which sends the message to patient care server 70via one or more wireless access points 80 and network 72).

Patient care server 70 receives the activity message from patientsupport apparatus 20 and notes the time at which the message wasreceived. The receipt of such a message resets a timer maintained atpatient care server 70. Such a timer is maintained for each patientsupport apparatus 20 in which patient care server 70 is in communication(and configured with patient care system 106). Whenever an activitymessage is received from one of these patient support apparatuses 20,patient care server 70 resets the timer for the particular patientsupport apparatus 20 from which the activity message was received. Inaddition to resetting the timers in response to such activity messages,patient care server 70 is configured to monitor the timers and issue analert for any of the timers that reach more than a first or secondthreshold. The first and second thresholds, in one embodiment, are thesame as the first and second thresholds used in steps 172 and 170 ofalgorithm 152, and the choice of which threshold to utilize is based onthe sleep state of the patient. Alternatively, patient care server 70may be configured to use only a single threshold regardless of whetherthe patient is awake or asleep. As will be discussed more below, whenusing multiple thresholds, patient care server 70 is apprised of thesleep status of the patient at another step in algorithm 150 (i.e. step190, discussed below).

For any one or more of the timers maintained at patient care server 70that exceed the corresponding threshold, patient care server 70 issuesan inactivity alert for those particular patient support apparatuses 20.The inactivity alert is processed in the same manner discussed abovewith respect to algorithm 152. That is, patient care server 70 sends outa message to one or more caregivers associated with the patient supportapparatus 20 that hasn't reported an activity message for longer thanthe corresponding threshold period of time. The message may be sent tothe mobile electronic device(s) 138 associated with the caregiver(s) forthat particular patient. The message may be a text, email, voicemessage, or some other type of message.

Returning back to step 184 of algorithm 150 (FIG. 6), if controller 58does not detect any patient-nurse communications at step 184, it movesto step 186. At step 186, controller 58 determines if any caregivercontrol has been activated since the last iteration of step 186. Step186 is the same as step 166 of algorithm 152 and refers to the samecaregiver controls (e.g. those on caregiver control panels 48 a and 48c, but not patient control panels 48 b). If the use of a caregivercontrol is detected at step 186, controller 58 proceeds to step 192where it sends out an activity message to patient care server 70, asdescribed above. If no caregiver control activity is detected at step186, controller 58 proceeds to step 188 where it determines if thepatient is asleep or awake. This is performed in the same manner as step168 of algorithm 152. If the patient is not asleep, controller 58returns to step 182 and proceeds in the manner previously discussed. Ifthe patient is asleep, controller 58 proceeds to step 190 where it sendsa sleep message to patient care server 70 informing the server 70 thatthe patient is currently asleep. As was noted, patient care server 70uses this message, in at least some embodiments, to determine whichthreshold time period to utilize before sending out an inactivity alertto the corresponding caregivers. If patient care server 70 utilizes onlya single time threshold, step 190 may be omitted from algorithm 150.

It will be understood that algorithm 150 may be modified in many of thesame manners as algorithm 152 discussed above. These include, but arenot limited to, changing the order of the steps, adding additional stepsand/or omitting one or more of the additional steps and/or modifying anyone or more of these steps. In one embodiment, in order to reduce thebandwidth that might otherwise be consumed by patient supportapparatuses 20 when a caregiver presses multiple buttons on one of thecaregiver controls panels 48 a and/or 48 c, algorithm 150 may bemodified consolidate the activity messages that are sent at step 192.Thus, for example, instead of sending out an activity message every timea caregiver control panel is activated, or every time patient-nurse callcommunication is detected, controller 58 can be configured to only sendout one activity message per given time period of caregiver activitydetection (e.g. one message every five minutes, ten minutes, an hour,etc.) Thus, for example, instead of sending ten activity messages out ifthe caregiver presses ten buttons within a short time period, controller58 may be configured to send only one message out in response to theinitial button press (or other caregiver control activation) and thensend no more activity messages out unless another button press (or othercaregiver control activation) is detected five minutes later (orwhatever the selected time period is). Still other modifications are ofcourse possible.

For either of algorithms 150 and 152, the threshold time periods (e.g.those used at steps 170, 172 of algorithm 152 or by patient care server70 in algorithm 150) are set by the manufacturer of the patient supportapparatus 20 and stored in the memory of patient support apparatus 20,in at least one embodiment. In such embodiments, these time thresholdscan be overridden by authorized healthcare personnel, either by usingone of the caregiver control panels 48 a, 48 c, or by sending a messageto patient support apparatus 20, such as via computer 120 or throughother means. In other embodiments, the patient support apparatuses 20include no time threshold(s) initially, and must have such threshold(s)input by an authorized person of the healthcare facility or otherauthorized individual. In any of these embodiments, as was notedpreviously, the time threshold(s) can be modified by authorizedpersonnel and/or can be dynamic and take into account such factors astime of day, location within the healthcare facility, diagnosis of thepatient, etc.

FIG. 7 illustrates one embodiment of a caregiver assignment monitoringalgorithm 154 according to the present disclosure. Caregiver assignmentalgorithm 154 is executed by patient care server 70 and involvescommunications with both patient support apparatuses 20 and one or moreother servers on network 72. Caregiver assignment algorithm 154 beginsat a step 200. In some embodiments, algorithm 154 begins automaticallyevery time patient care server 70 is powered up. In other embodiments,algorithm 154 runs automatically in response to a passage of apredetermined time interval, while in still other embodiments, algorithm154 runs in response to a message from an authorized user. In stillother embodiments, algorithm 154 may be configured to begin in responseto a combination of two or more of these factors.

After beginning at step 200, patient care server 70 proceeds to step 202where it receives a list of all of the patient support apparatuses 20that are located within the healthcare facility and that are desirablymonitored. In some embodiments, this list is input into patient careserver 70 manually by an authorized individual, and in some suchembodiments, it includes all of the patient support apparatuses 20 thatthe healthcare facility has purchased and obtained. In otherembodiments, the list may be a subset of the entire set of patientsupport apparatuses 20 within the healthcare facility. Still further, insome embodiments, patient care server 70 automatically generates thelist of all patient support apparatuses 20 by tallying the list ofpatient support apparatuses 20 with which it is able to communicate.This may be done by sending messages to all of the patient supportapparatuses 20, or it may be done by querying patient support apparatusserver 132, which may itself contain a list of all of the patientsupport apparatuses 20 within the healthcare facility. Still othervariations are possible.

After obtaining the list of patient support apparatuses 20 at step 202,patient care server 70 proceeds to step 204 of algorithm 154 (FIG. 7).At step 204, patient care server 70 is programmed to send a query towhichever server (or servers) on network 72 contains a list of caregiverassignments. The particular server that contains this information isidentified to patient care server 70 during installation of patient caresystem 106 (and/or modified after installation, as appropriate) suchthat patient care server 70 stores the data necessary to communicatewith that particular server (e.g. IP address, authenticationcredentials, etc.). Depending upon the particular healthcare facility,this information may be stored in at least three different manners.First, a particular healthcare facility may assign caregivers tospecific patients. Second, a particular healthcare facility may assigncaregivers to specific locations (e.g. rooms and/or bed bays within aroom). And third, a particular healthcare facility may assign caregiversto specific patient support apparatuses 20. Patient care system 106 andserver 70 are configured to accommodate any of these three scenarios,and follow one of paths 206, 208, and 210 depending upon how aparticular healthcare facility has chosen to assign caregiverresponsibilities.

Patient care server 70 follows path 206 if the healthcare facilityassigns caregivers to locations (rooms, bed bays, etc.), and thereforeproceeds to step 212 after completing step 204. If the healthcarefacility assigns caregivers to patient support apparatuses 20, thenserver 70 follows path 208 and proceeds to step 214 after completingstep 204. Finally, if the healthcare facility assigns caregivers toindividual patients, then server 70 follows path 210 and proceeds tostep 216 after step 204. These three different paths are discussed morebelow.

If patient care server 70 follows path 206, then the healthcare facilityhas chosen to assign caregivers to rooms and/or bed bays within roomsand patient care server 70 determines the locations of the patientsupport apparatuses 20 at step 212 (FIG. 7). In some embodiments,patient care server 70 determines the list of patient support apparatuslocations at step 212 by sending a query to patient support apparatusserver 132 for this list. In other embodiments, patient care server 70generates the list by sending out a request to each patient supportapparatus asking it to send it its location information. Still othermethods of determining the locations of the patient support apparatusesare possible. After getting the list of patient support apparatuslocations at step 212, patient care server 70 proceeds to step 218 whereit determines which caregivers has been assigned to which patientsupport apparatuses 20. This is accomplished by sending an inquiry towhatever server contains the list of caregiver-location assignments. Inthe example shown in FIG. 3, caregiver assignment server 112 containsthis list (table 110), so patient care server 70 sends an inquiry toserver 112 asking it for the list of caregiver-room assignments. Oncethis list is obtained, patient care server 70 proceeds to step 218,which will be discussed further below.

If patient care server 70 follows path 208, then the healthcare facilityhas chosen to assign caregivers to specific patient support apparatuses20. In such a facility, patient care server 70 proceeds from step 204directly to step 214. At step 214, patient care server 70 sends arequest to whichever server on network 72 contains the data correlatingcaregivers to patient support apparatuses 20. In the example shown inFIG. 3, patient support apparatus 20 contains table 130 that mapsspecific patient support apparatuses 20 to locations, and server 112contains table 110 that maps locations to caregivers, so in thisinstance patient care server 70 is configured to send a request to bothpatient support apparatus server 132 and caregiver assignment server 112in order to determine which caregivers are responsible for whichindividual patient support apparatuses 20. After obtaining these lists,patient care server 70 is able to determine what caregivers are assignedto what specific patient support apparatuses 20 at step 214, and patientcare server 70 then proceeds to step 218.

If patient care server 70 follows path 210, then the healthcare facilityhas chosen to assign caregivers to specific patients. In such afacility, patient care server 70 proceeds from step 204 directly to step216. At step 216, patient care server sends a request to ADT server 84asking for the patient-room data contained within table 108. Patientcare server also sends a request either to patient support apparatuses20 themselves or patient support apparatus server 132 for the locationsof each of the patient support apparatuses 20. Patient care server 70also sends a request to caregiver assignment server 112 for thecaregiver-patient assignments. After receiving this information, patientcare server 70 proceeds to step 214 where it uses the caregiver-patientassignments and patient-room assignments to determine which caregiversare assigned to which rooms. Further, from this data and the patientsupport apparatus and room location data, patient care server 70determines which caregivers are assigned to which patient supportapparatuses 20. Patient care server 70 then proceeds to step 218.

Regardless of which path 206, 208, or 210 algorithm 154 follows, patientcare server 70 determines at step 218 whether all of the patient supportapparatuses 20 have been assigned to a caregiver or not. If they allhave, patient care server 70 returns to step 200. If they have not,patient care server 70 proceeds to step 220 where it determines whetherthose patient support apparatuses 20 that have not been assigned to acaregiver are occupied or not. This may be done in the same mannerdiscussed previously (e.g. by receiving data from load cells 54 and/orpatient presence sensor(s) 62 onboard the patient support apparatuses 20indicative of patient presence or absence). If the patient supportapparatuses 20 that have not been assigned a caregiver are determined tobe unoccupied at step 220, patient care server 70 returns back to step200. If any of the patient support apparatuses 20 that have not beenassigned a caregiver are occupied by a patient, as determined in step220, patient care server 70 proceeds to step 222 and issues an alert.

The alert issued at step 222 (FIG. 7) is an alert indicating that theremay be a patient within the healthcare facility who has not beenassigned a caregiver, and therefore may accidentally be overlooked. Thealert is sent in any of the same manners discussed above as theinactivity alerts are sent for algorithms 150 or 152. The alert notifiesappropriate personnel that no caregiver has been assigned to aparticular patient support apparatus 20, and therefore there is apossibility that the patient associated with that patient supportapparatus 20 may not be properly looked after by a caregiver. Caregiverassignment monitoring algorithm 154 therefore provides a monitoringservice that acts as a double check on the healthcare facility'scaregiver assignment system to ensure that all patients are assigned acaregiver, or if they are not, appropriate personnel are notified.Algorithm 154 therefore helps reduce the possibility of a patient beingoverlooked. As noted above, algorithm 154 may run separately and/or inaddition to any of the algorithms 150 and/or 152 executed by patientsupport apparatuses 20, and/or it may run separately or in addition toany of the other algorithms 156, 158, 270 and/or 300 that will bediscussed in more detail below.

FIG. 8 depicts EMR update monitoring algorithm 156 according to oneembodiment of the present disclosure. In general, EMR updatingmonitoring algorithm 156, which is executed by patient care server 70,monitors updates to the electronic medical records of patients andissues an alert if there are no such updates for a given patient formore than a set amount of time. Algorithm 156 therefore flags patientswhose EMRs have not been recently updated so that caregivers arenotified of such patients. The caregivers can then use these flaggedpatients to double check their care and make sure that the lack of EMRupdates has not been due to oversight or neglect, or to correct suchoversight or neglect before it becomes problematic. EMR updatemonitoring algorithm 156 therefore serves as yet another manner ofhelping to prevent unintentional neglect of patients within thehealthcare facility.

EMR update monitoring algorithm 156 begins at step 230. Patient careserver 70, in at least one embodiment, is configured to automaticallyand repetitively start algorithm 156 such that all of the patient'swithin the healthcare facility have their EMR data monitored while inthe healthcare facility. In other embodiments, patient care server 70may be programmed to start at step 230 periodically, or it may beconfigured to begin execution in response to a manual command receivedfrom an authorized individual within the healthcare facility. In stillother embodiments, algorithm 156 may be triggered by any combination ofthese events, or still other events.

After starting at step 230, patient care server 70 proceeds to step 232where it receives a list of all of the patient support apparatuses 20within the healthcare facility. Step 232 may be carried out in any ofthe same manners as step 202 of algorithm 154 discussed above. Afterretrieving this list at step 232, patient care server 70 proceeds tostep 234 where it determines the patient that has been assigned to eachpatient support apparatus 20. This may be accomplished in differentmanners, depending upon how the particular healthcare facility assignscaregivers. In the example of FIG. 3, patient care server 70 obtains thelocation of patient support apparatuses 20 either directly from thepatient support apparatuses 20 themselves, or from patient supportapparatus server 132. Also in the example of FIG. 3, patient care server70 obtains the patient-to-room assignments from ADT server 84. Using thelocation information of each patient support apparatus 20 and theidentity of patients assigned to each location (from ADT server 84),patient care server is able to determine what patients have beenassigned to what patient support apparatuses 20. After thisdetermination is made, patient care server 70 proceeds to step 236.

At step 236 (FIG. 8), patient care server 70 queries EMR server 102 forany recent updates to the EMR of each patient who has been assigned to apatient support apparatus 20. After receiving this information, patientcare server 70 proceeds to step 238 where it checks to see if the lastEMR update has occurred within a threshold amount of time. The thresholdused at step 238 may be configured and customized by authorizedpersonnel of the healthcare facility and may be the same as, ordifferent from, any of the other time thresholds discussed herein (e.g.the first or second thresholds used at steps 170 or 172 of algorithm152). In some embodiments, the threshold may be on the order of 2-6hours. However, in some embodiments, the threshold may be dynamic andautomatically vary depending upon any one or more of the following: theparticular patient (e.g. his or her diagnosis and/or prescribedtreatment), the particular location of the patient (e.g. post-oplocations versus normal acute care, etc.), the time of day (e.g. longerthresholds at night), and/or the content of the EMR update itself (e.g.some types of updates might correlate to different thresholds). Stillother factors may be used for such dynamic thresholds.

If the EMR of a particular patient has been updated within the thresholdperiod of time, as determined at step 238, patient care server 70returns to step 230 and re-starts algorithm 156. If no EMR updates havebeen made within the threshold period of time, as determined at step 283(FIG. 8), patient care server 70 proceeds to step 240. At step 240,patient care server 70 determines if the patient support apparatus 20 ofthe patient whose records have not been updated for longer than thethreshold time period is currently occupying the patient supportapparatus 20. If not, patient care server 70 returns back to step 230and restarts algorithm 156. On the other hand, if the patient supportapparatus 20 is occupied, as determined at step 240, patient care server70 proceeds to step 242 where it issues an inactivity alert. Theinactivity alert is issued and forwarded to the appropriate caregiversin any of the same manners discussed above with respect to the otherinactivity alerts mentioned herein. As with all of the inactivityalerts, the inactivity alert issued at step 242 may be customized and/orconfigured in any of the manners discussed herein (e.g. targeted tospecific caregivers, sent in a particular manner (e.g. email, text,voice, etc.), and/or otherwise customized). After issuing the alert atstep 242, patient care server 70 returns back to step 230 and restartsalgorithm 156.

As with all of the algorithms discussed herein, algorithm 156 may bemodified in a number of different manners, including, but not limitedto, re-ordering the steps shown in FIG. 8, adding one or more additionalsteps, and/or omitting one or more of the illustrated steps. As but oneexample, in some embodiments, algorithm 156 is modified to not inquirewhether or not the patient support apparatuses are occupied or not, butinstead issues an alert for any patient whose EMR has not been updatedwithin the threshold amount of time, regardless of whether or not theyare positioned on the patient support apparatus 20 or not (i.e. step 240is omitted). In some such embodiments, algorithm 156 may be furthermodified to omit step 232 and/or 234, and simply check for EMR updatesfor all patients and issue an alert for those whose records have notbeen recently updated, regardless of the specific patient supportapparatus that each patient has been assigned to. Still other variationsare possible.

FIG. 9 illustrates a prescribed therapy monitoring algorithm 158according to one embodiment of the present disclosure. As with the otheralgorithms discussed herein, algorithm 158 may be executed by itself, orit may be executed in conjunction with one or more of the otheralgorithms. In general, prescribed therapy monitoring algorithm 158,which is executed by patient care server 70, examines the electronicmedical records of a patient for prescribed therapies (including, butnot limited to medications, treatments, and prescribed caregiveractivities) and monitors updates to the electronic medical records ofthose patients to see if those prescribed therapies are completed withina timely manner. If they are not, patient care server 70 issues analert. Algorithm 158 therefore flags patients whose EMRs have not beenupdated in a manner that matches what would be expected given theprescribed therapy for the patient. The caregivers can then use theseflagged patients to either perform the neglected therapy or update theEMR to indicate that the prescribed therapy has been accomplished. Ineither case, prescribed therapy monitoring algorithm 158 thereforeserves as yet another manner of helping to prevent overlooking patientsand/or their treatment while staying within the healthcare facility.

Prescribed therapy monitoring algorithm 158 begins at a step 250. Step250 may be triggered automatically and/or repetitively and/or inresponse to any of the triggering events discussed above with respect toalgorithms 154 and/or 156. After step 250, patient care server 70proceeds to step 252 where it receives a list of patient supportapparatuses 20. Step 252 is the same as step 232 of algorithm 156, andtherefore need not be discussed further. From step 252, patient careserver 70 proceeds to step 254 where it determines which patient isassigned to each patient support apparatus 20. Step 254 is the same asstep 234 discussed above with respect to algorithm 156, and thereforedoes not need to be described again.

After step 254, patient care server 70 proceeds to step 256 where itqueries EMR server 102 for EMR records identifying any one or more of aplurality of prescribed actions for each of the patients. Although theterm “prescribed therapy” is used herein, this term is not meant toexclude prescribed medications, prescribed treatments, prescribedtesting, the measuring or monitoring of physiological characteristics,physical, occupational, or psychological therapy, the collection ofother medical treatment data, and/or other types of activities that areprescribed or ordered by a caregiver. Examples of a prescribed therapyevent include measuring selected physiological characteristics of thepatient, such as respiratory function, blood glucose levels, bloodpressure, heart rate, body weight, fluid intake and discharge rates,caloric intake, and any other medical treatment data collected from thepatient. Other examples include performing an activity that is to bedocumented to the particular patient record stored in EMR server 102,such as, but not limited to, visiting the patient at a regular timeinterval, taking a weight reading of the patient; performing a fall riskor bed sore risk assessment of the patient, etc. The prescribedtherapies refer to not only therapies that are individually prescribedfor a particular patient, but also therapies and/or protocols that aregenerally applicable to all patients within the healthcare facility(and/or all patients within a particular location in the facility,and/or all patients that have been diagnosed with a particularcondition, etc.).

After obtaining the prescribed therapy information from EMR server 102at step 256, patient care server 70 proceeds to step 258 where isqueries the patient support apparatuses 20 for any prescribed therapiesthat have been input into patient support apparatus 20 (and which maynot be reflected in the records stored in EMR server 102). For example,in some instances, the prescribed therapy may prescribe that a patientbe turned every so often, and a turning schedule may be input into thememory of the patient support apparatus 20. Other therapy prescriptionsmay also be input into the patient support apparatus 20, such as, butnot limited to, a weighing schedule, a mobility schedule (e.g. aprescribed amount of time that the patient exits from patient supportapparatus 20), a mattress therapy, etc. Any such therapies that havebeen input into patient support apparatus 20 are sent to patient careserver at step 258.

After querying patient support apparatuses 20 at step 258 for prescribedtherapies, patient care server 70 proceeds to step 260 where it queriesthe patient support apparatuses 20 for information indicating that oneor more of the prescribed therapies (whether stored on the patientsupport apparatus 20 or in the EMR) have been accomplished. For example,in some instances, the prescribed therapy may prescribe that a patientbe turned every so often, and patient support apparatuses 20 areconfigured to detect such turning. If such a turning protocol has beeninstituted for a particular patient, patient care server 70 queries thepatient support apparatus 20 for that particular patient at step 258 tosee if the patient has, in fact, been turned. Patient care server 70also queries the patient support apparatus 20 for any and all otherprescribed therapies that can be detected by the patient supportapparatus 20 (e.g. weighing the patient, transferring the patient,etc.). After receiving any information from patient support apparatuses20 that would indicate the successful completion one or more prescribedtherapies, patient care server 70 proceeds to step 262.

At step 262, patient care server 70 queries the EMR server 102 to see ifthere are updates to the EMR records indicating that the prescribedtherapies have been completed within either a prescribed time period, oran acceptable time window. The acceptable time window may be customizedand/or configured by authorized healthcare personnel and may vary fordifferent prescribed therapies. For example, a prescription to have anX-ray taken may be assigned a time threshold different than, say, aprescription to have a vital sign reading taken from the patient. Atstep 264, patient care server 70 determines if data exists indicatingthat the prescribed therapies have taken place within the prescribedtime window or the acceptable time window. If they have not, patientcare server 70 proceeds to step 266 and issues a therapy inaction alert.The therapy inaction alert may be issued in any of the same mannersdescribed above for any of the other alerts (e.g. the inactivity alertof algorithms 150, 152, etc.). If patient care server 70 determines atstep 264 that the data indicates that the prescribed therapy has beencompleted, or the prescribed or acceptable time period has not yetexpired, it returns to step 250. Algorithm 158 therefore serves as anautomated monitoring system that helps ensure that prescribed actionsare taken in a timely manner and, if they are not, alerts areautomatically issued to the appropriate personnel within the healthcarefacility.

FIG. 10 illustrates a patient neglect algorithm 270 according to anotherembodiment of the present disclosure. Patient neglect algorithm 270 maybe executed in combination with any one or more of the algorithmspreviously described herein, or it may be executed by itself. As will beapparent from the following discussion, patient neglect algorithm 270combines together some aspects from multiple ones of the algorithmspreviously discussed.

Patient neglect algorithm 270 includes one or more steps that areexecuted on patient support apparatuses 20, one or more steps that areexecuted on patient care server 70, one or more steps that are executedon EMR server 102, and one or more steps that are executed on one ormore of the mobile electronic devices 138 carried by caregivers. Turningfirst to the steps executed on the patient support apparatuses 20,controller 58 of patient support apparatuses 20 detects if a caregiveris present adjacent to patient support apparatus 20 (e.g. within thesame room) at a step 272. Step 272 is carried out using one or more ofcaregiver presence sensors 144. Controller 58 of patient supportapparatus 20 reports to patient care server 70 whether a caregiver isdetected or not at step 272. At step 274, patient care server 70receives those results and stores them in memory, including a time stampof the results. At step 276, controller 58 of patient support apparatus20 also detects whether a caregiver is using patient support apparatus20. This step is carried out in the same manner as steps 164 and 166 ofalgorithm 152. That is, controller 58 checks to see if any of thecontrols on any of the caregiver control panels 48 a or 48 c have beenactivated, or if a caregiver has made audio contact with the patient viathe nurse call functionality built into the patient support apparatus 20(e.g. nurse call button 90, speaker 96, and microphone 88). Controller58 reports the results of step 276 to patient care server 70 and patientcare server 70 stores these results, including a time stamp, at step278.

Patient care server 70 also repetitively queries EMR server 102 at step280 for new patient activities (e.g. updates), such as, but notincluding, rounding (FIG. 10). At step 282, EMR server 102 reports suchnew updates, if any, to patient care server 70. At step 284, patientcare server 70 analyzes the EMR data received both from the patientsupport apparatuses 20 and from EMR server 102 in order to determine ifthe patient is potentially being neglected or not. This analysis iscarried out in the same manner as the analyses of steps 168-174 ofalgorithm 152 and steps 238-242 of algorithm 156, in at least oneembodiment. That is, patient care server 70 determines if thecaregiver's presence at the patient support apparatus 20 has either beendirectly detected by caregiver presence sensors 144, or indirectlydetected by usage of one of the caregiver control panels within athreshold period of time. It also determines if the patient hascommunicated with the caregiver more recently than a threshold period oftime. Still further, it analyzes the EMR records to see if they havebeen updated within another threshold amount of time. If the caregiverhasn't been recently (i.e. within the time threshold) detected at thepatient support apparatus 20, and the caregiver hasn't recentlycommunicated with the patient via the nurse call functionality, and thepatient's EMR records have not been updated recently, then patient careserver 70 determines that the patient may be experiencing neglect, andit proceeds to step 286. It will be understood that in carrying out thisanalysis, different thresholds may be used when examining each of thedifferent data points in step 284, and that such thresholds may varybased upon any of the factors discussed above (e.g. whether the patientis asleep, the time of day, the location of the patient supportapparatus 20, the diagnosis of the patient, the specific type of EMRupdate, etc.). In other words, the thresholds used in step 284 maycorrespond to any of the various thresholds previously described, andtheir variants, with respect to algorithms 152 and/or 156.

At step 286 (FIG. 10), the caregiver's portable electronic device 138receives a text, email, phone call, or other notification that aparticular patient may be being neglected. As noted previously, thecommunication to electronic device 138 is sent by patient care server 70in some embodiments, while in other embodiments it may be sent by anintermediary server in response to a message from patient care server70. The caregiver's portable electronic device 138 is in communicationwith network 72 and patient care server 70. In response to the alertreceived at step 286, the caregiver is therefore able to send a replyand/or acknowledgement back to patient care server 70. Thisreply/acknowledgement is received by patient care server 70 at step 288.In some embodiments, the reply/acknowledgement may include a messageindicating that the patient has been checked on, that his or her EMRrecord has been updated, or that the caregiver has taken some otheraction to remedy the cause of the alert. In such embodiments, patientcare server 70 is configured to send a message to the EMR server 102 atstep 290 indicating that such a remedy has taken place. Alternatively,patient care server 70 is configured to send a message at step 288 toEMR server 102 that indicates that the caregiver has acknowledged thealert message. EMR server 102 stores whatever message it receives, andits contents, at step 290. After sending the message at step 288,patient care server 70 returns to step 284 and carries out thepreviously described analyses using fresh data from the patient supportapparatus 20 and EMR server 102, as well as one or more reset timersused for determining the various time thresholds utilized in step 284.

If patient care server 70 determines at step 284 that no cause for analert exists, it proceeds to step 292 where it waits for a predefinedamount of time. After waiting for the predefined amount of time, patientcare server 70 returns to step 284 and carries out the previouslydescribed analyses using fresh data from the patient support apparatus20 and EMR server 102, but not any reset timers. Depending upon theoutcome of that analyses, patient care server 70 then proceeds to eitherstep 286 or step 292 and follows those steps in the manners previouslydescribed.

As with all of the algorithms described herein, algorithm 270 may bemodified in a number of different manners, including, but not limitedto, re-ordering any of the steps shown in FIG. 10, adding one or moreadditional steps, omitting one or more of the illustrated steps, and/orchanging the device that performs one or more of the steps. As but oneexample, in some embodiments, algorithm 270 is modified to offload some,or all, of the computations carried out by patient care server 70 to themobile electronic devices 138 carried by the caregivers. In suchembodiments, mobile device 138 carries out the analysis of step 284.Further, in some such embodiments, the mobile device 138 may communicatedirectly with EMR server 102 and/or patient support apparatuses 20directly, thereby avoiding the need for patient care server to act as anintermediary. Indeed, in at least one embodiment, patient care server 70is omitted and the functions of the patient care server 70 are performedby mobile electronic devices 138 and/or patient support apparatuses 20.Still other variations are possible.

FIG. 11 illustrates a staff assignment error detection algorithm 300according to another embodiment of the present disclosure. Staffassignment error detection algorithm 300 may be executed in combinationwith any one or more of the algorithms previously described herein, orit may be executed by itself. As will be apparent from the followingdiscussion, staff assignment error detection algorithm 300 performs afunction similar to that of caregiver assignment monitoring algorithm154 and uses one or more steps that are similar to those of algorithm154.

Staff assignment error detection algorithm 300 includes one or moresteps that are executed on patient support apparatuses 20, one or moresteps that are executed on patient care server 70, one or more stepsthat are executed on EMR server 102, and one or more steps that areexecuted on one or more of the mobile electronic devices 138 carried bycaregivers. Staff assignment error detection algorithm 300 begins atstep 302 where controller 58 of patient support apparatus 20 determinesif a patient is present on the patient support apparatus 20 bydetermining if the amount of weight detected load cells 54 is greaterthan a threshold. Step 302 may be modified and/or supplemented in avariety of different manners. For example, one or more patient detectionsensors 62 may be utilized to determine if the patient is present ornot, either alone or in addition to the load cell readings. Regardlessof the specific sensors used, controller 58 of patient support apparatus20 sends a message to patient care server 70 indicating whether thepatient is present or not.

Patient care server 70 retrieves a list of caregiver assignments at step304 of algorithm 300 (FIG. 11). In some embodiments, these are retrievedin the same manner as steps 204-216 of algorithm 154. In otherembodiments, the retrieval of the caregiver assignments may be carriedout in other manners. As shown in FIG. 11, the caregiver assignment datais stored electronically on one or more servers on network 72 at step308. These servers include, but are not limited to, the EMR server 102and the nurse call server 92. The caregiver assignment data may beentered using one or more of the caregiver's mobile electronic devices138, as indicated at step 310. Other devices may also or additionally beused to enter the caregiver assignment data.

After retrieving the list of caregiver assignments at step 304, patientcare server 70 proceeds to step 306 where it retrieves a list ofconnected patient support apparatuses 20, their locations, andinformation indicating whether the patient is currently occupying thepatient support apparatus 20 or not. The list of connected patientsupport apparatuses 20 is retrieved, in some embodiments, in any of themanners that step 202 of algorithm 154 is carried out, as was previouslydiscussed. Other manners can, of course, be used. The location of thepatient support apparatuses 20 may be determined in the same manner asstep 212 of algorithm 154, or it may be carried out in other manners.The data indicating whether the patient support apparatuses 20 areoccupied or not comes directly from the patient support apparatuses 20via step 302, described above.

After receiving the information of step 306, patient care server 70proceeds to step 312 where it determines if there are any mismatchesbetween the occupied patient support apparatuses 20 and the caregiverassignments, particularly any occupied patient support apparatuses 20that do not have a caregiver assigned to them. Step 312, in someembodiments, is carried out in the same manner as steps 218 and 220 ofalgorithm 154, as described above. If there is any mismatch, patientcare server 70 sends a message to the appropriate caregiver mobileelectronic device 138, as indicated at step 314. This alert message maybe accomplished in the same manner as step 222 of algorithm 154. If nomismatch is detected at step 312, patient care server 70 proceeds tostep 316 where it waits for a predefined amount of time before returningto steps 304, 306, and 312. When patient care server 70 gets to step 312after completing step 316 (i.e. after completing steps 304 and 306again), it performs step 312 again using a fresh set of data (i.e. afresh list of caregiver assignments, a fresh list of occupied patientsupport apparatuses 20, and a fresh listing of the locations of thosepatient support apparatuses 20). This fresh data is retrieved when steps304 and 306 are repeated, and patient care server 70 uses this freshdata to perform a new analysis at step 312.

If an alert is sent out to one of more of the caregivers' mobileelectronic devices 138, as indicated at step 314 (FIG. 11), the mobileelectronic devices 138 are configured to allow the caregiver to correctthe mismatch and/or acknowledge the alert message. When taking either ofthese actions, the mobile electronic device 138 sends a message back topatient care server 70 that is received and processed at step 318.Patient care server 70 is configured to send a message to the EMR server102 and/or the nurse call server 92 (or whatever server stores thecaregiver assignment data) at step 320 indicating that the mismatch hasbeen acknowledged and/or corrected. The recipient server stores thismessage and its contents. After sending the message at step 318, patientcare server 70 proceeds to step 316 and waits for a predefined amount oftime before returning back to step 304 in the manner previouslydescribed.

In any of the algorithms described above that monitor patient-caregiverinteractions, such algorithms may be modified and/or supplemented withdata obtained from caregiver tracking server 122. As noted, trackingserver 122 receives real time caregiver location data and transmits thecaregiver location data to patient care server 70. The caregiverlocation data indicates the location of caregivers within the healthcarefacility. Patient care server 70 also receives the location of eachparticular patient support apparatus 20 within the healthcare facility,as noted. The patient care server 70 can utilizes the patient supportapparatus location data and the caregiver location data to determine ifa caregiver has visited a particular location within the healthcarefacility within a predetermined amount of time. The patient care server70 issues an inactivity alert if a caregiver has not visited thelocation of an occupied patient support apparatus within one of thethreshold amounts of time.

It will be understood that any of the features, functions, and/or stepsof any of the algorithms discussed herein may be combined with any ofthe features, functions, and/or steps of any of the other algorithmsdescribed herein.

The various embodiments of the patient care system 106 described hereinare configured to help healthcare facility staff reduce or avoidcaregiver assignment errors and caregiver inattention issues, which maylead to patient neglect. The system generates and issues alerts whensuch errors or issues are identified. For example, an alert may beissued when a patient has not been attended to by a caregiver within aperiod of time greater than a certain period, or when a caregiver hasnot been assigned to a particular location within the healthcarefacility to which a patient has been assigned. The patient supportapparatus communicates with multiple other conventional healthcarefacility systems and devices to gather and share information and data tohelp caregivers avoid neglecting a patient.

Various additional alterations and changes beyond those alreadymentioned herein can be made to the above-described embodiments. Thisdisclosure is presented for illustrative purposes and should not beinterpreted as an exhaustive description of all embodiments or to limitthe scope of the claims to the specific elements illustrated ordescribed in connection with these embodiments. For example, and withoutlimitation, any individual element(s) of the described embodiments maybe replaced by alternative elements that provide substantially similarfunctionality or otherwise provide adequate operation. This includes,for example, presently known alternative elements, such as those thatmight be currently known to one skilled in the art, and alternativeelements that may be developed in the future, such as those that oneskilled in the art might, upon development, recognize as an alternative.Any reference to claim elements in the singular, for example, using thearticles “a,” “an,” “the” or “said,” is not to be construed as limitingthe element to the singular.

What is claimed is:
 1. A patient support apparatus comprising: a litterframe; a support deck supported on the litter frame and adapted tosupport a patient thereon; and a sensor configured to detect caregiveractivity; a transceiver adapted to communicate with a server; a timer;and a controller in communication with the sensors, the timer, and thetransceiver, the controller configured to send a caregiver inactivitymessage to the server when caregiver activity has not been detected fora period of time greater than a predetermined period of time.
 2. Thepatient support apparatus of claim 1 further comprising a caregivercontrol panel, the caregiver control panel including controls for atleast one of raising and lowering the litter frame, changing a positionof a section of the support deck, activating and deactivating a brake,controlling a patient support apparatus exit alert, taking a weightreading, locking out one or more functions, or setting an alert; andwherein detecting caregiver activity includes receiving input from thecaregiver control panel.
 3. The patient support apparatus of claim 1wherein the predetermined period of time for detecting caregiveractivity is received by the controller from at least one of a patientsupport apparatus server in communication with the patient supportapparatus via the server, a caregiver control panel coupled to thepatient support apparatus, or an electronic medical records (EMR) serverin communication with the patient support apparatus via the server. 4.The patient support apparatus of claim 1 wherein the sensor is adaptedto detect audio communication between the patient and a remotecaregiver, the audio communication taking place via a nurse callcommunication module coupled to the patient support apparatus.
 5. Thepatient support apparatus of claim 1 further comprising a clock, whereinthe predetermined period of time varies based on a time of day.
 6. Thepatient support apparatus of claim 1 further comprising a sleep sensoradapted to sense a patient's sleep state and to communicate with thecontroller, and wherein the predetermined period of time varies based onthe patient's sensed sleep state.
 7. The patient support apparatus ofclaim 1 further comprising a patient control panel and a caregivercontrol panel, wherein the controller is adapted to detect caregiveractivity any time a control on the caregiver control panel is activated,and wherein the controller does not detect caregiver activity when thepatient control panel is activated.
 8. The patient support apparatus ofclaim 1 further comprising a patient presence sensor configured todetect a presence of a patient on the support deck and to communicatewith the controller, and wherein the predetermined period of time variesbased on the presence of a patient on the support deck, and wherein thecaregiver inactivity message is not sent if a patient is not present onthe support deck when the predetermined period of time expires.
 9. Apatient support apparatus comprising: a litter frame; a support decksupported on the litter frame and adapted to support a patient thereon;a caregiver control panel comprising a plurality of caregiver controlsadapted to be activated by a caregiver; a transceiver adapted tocommunicate with a server; and a controller in communication with thecaregiver control panel and the transceiver, the controller adapted tosend a caregiver activity message to the server in response to thecaregiver controls being activated.
 10. The patient support apparatus ofclaim 9 wherein the controller is further adapted to send a caregiveractivity message in response to a caregiver communicating with thepatient via a nurse call speaker communicatively coupled to the patientsupport apparatus.
 11. The patient support apparatus of claim 9 furthercomprising one or more caregiver control panels, wherein the controlleris adapted to send a caregiver activity message to the server inresponse to any of the caregiver control panels being activated.
 12. Thepatient support apparatus of claim 11 wherein the controller is furtheradapted to send one caregiver activity message to the server formultiple caregiver control panel activations when the multipleactivations occur within a predefined period of time.
 13. The patientsupport apparatus of claim 11 wherein each of the caregiver controlpanels includes controls for at least one of raising and lowering thelitter frame, changing a position of a section of the support deck,activating and deactivating a brake, controlling a patient supportapparatus exit alert, taking a weight reading, locking out one or morefunctions, or setting an alert.
 14. The patient support apparatus ofclaim 9 further comprising a patient presence sensor configured todetect a presence of a patient on the support deck and to communicatewith the controller, and wherein the controller is adapted to send acaregiver inactivity message to the server when the caregiver controlpanel has not been activated within a predetermined time period, but tonot send the caregiver inactivity message if a patient is not present onthe support deck when the predetermined time period expires.
 15. Apatient support apparatus system for use within a healthcare facilitycomprising: a patient support apparatus comprising: a litter frame; asupport deck supported on the litter frame and adapted to support apatient thereon; a sensor adapted to detect a presence of the patient; atransceiver; and a controller in communication with the sensor and thetransceiver; and a server in communication with the patient supportapparatus and the controller via the transceiver, the server furtherbeing in communication with a caregiver assignment server that storescaregiver assignments to locations within the healthcare facility, theserver configured to receive location data regarding a current locationof the patient support apparatus to determine if a caregiver has beenassigned to the current location of the patient support apparatus, andto issue an alert if the server determines that a caregiver has not beenassigned to the current location of the patient support apparatus. 16.The patient support apparatus system of claim 15 wherein the controlleris further adapted to not send an alert if the patient is determined bythe sensor to be absent from the support deck.
 17. The patient supportapparatus system of claim 15 wherein the patient support apparatusfurther includes a location detector adapted to receive a locationidentifier from a fixed locator when the patient support apparatus ispositioned adjacent the fixed locator, the controller is adapted toforward the location identifier to the server, and the server is adaptedto use the location identifier to determine which room within thehealthcare facility the patient support apparatus is currentlypositioned in.
 18. The patient support apparatus system of claim 15wherein the server is configured to request the caregiver assignmentsfrom the caregiver assignment server when at least one of the followingoccurs: the current location of the patient support apparatus changes,or a caregiver assignment changes.
 19. The patient support apparatussystem of claim 15 further comprising a location detector adapted toreceive a location identifier from a fixed locator when the patientsupport apparatus is positioned adjacent the fixed locator, wherein theserver is configured to receive caregiver location data from a real timelocating and tracking server indicating locations of caregivers withinthe healthcare facility, the server further adapted to use the locationdata to determine if a caregiver has visited a location within thehealthcare facility corresponding to the location identifier within apredetermined amount of time and to issue an inactivity alert if acaregiver has not visited the location corresponding to the locationidentifier within the predetermined amount of time.
 20. The patientsupport apparatus system of claim 15 the server further being incommunication with an electronic medical records (EMR) server thatstores patient records, the server configured to retrieve a particularpatient record from the EMR server corresponding to the patient todetermine if updates to the particular patient record have occurredwithin a predetermined amount of time, and to issue an inactivity alertif the particular patient record has not been updated within thepredetermined amount of time.